Psychoanalytic inpatient psychotherapy of depression – Two naturalistic samples throughout the course of a decade

Background: While the general effectiveness of psychodynamic inpatient psychotherapy has been established, very few studies have specifically investigated the effectiveness of psychodynamic inpatient treatment of depression, though depressed patients represent the largest group of inpatients.

Method : This study investigated two naturalistic samples of depressed patients regarding treatment outcome as well as clinical and treatment characteristics. Patients were treated in a psychoanalytical psychosomatic hospital unit. Data was collected from 2000 to 2002 (N=234) and from 2008 to 2010 (N=514). Data was acquired at admission and discharge.

Results: The findings reveal high pre-post effect sizes for symptom reduction (SCL-90-R), general functioning (GAF) and medium changes of interpersonal problems (IIP). The improvement on the IIP was significantly higher for patients with comorbid personality disorder. Based on therapist ratings, the sample treated from 2008-2010 showed higher levels of impairment on several levels: chronic, complex, functional (GAF) and structural (OPD).

Conclusion: Findings indicate that patients show substantial short-term benefit following psychoanalytic inpatient psychotherapy, as practiced under naturalistic conditions. Open questions remain regarding the long-term nature of these benefits and the possible influence of placebo-effects.     

Reflective team and process-oriented supervision – a case study on differences

To meet the Swedish healthcare legislation’s requirements for evidence-based care, a work model for reflection has been developed, called a reflective team (RT). Because this RT model can be perceived as either a competitor of or a complement to caring supervision, this case study aims to explore what distinguishes these two in psychiatric care. Five members of one RT who are psychiatric nurses with previous experiences in caring supervision were interviewed. The transcribed interviews were analysed according to phenomenography. The findings reveal three qualitatively separated categories, which describe differences in focus, competencies, and relationships between confirmation and demands. It is concluded that an RT by no means replaces supervision. Instead, both can contribute to care improvement by complementing each other and increasing the professionalism of psychiatric nurses.     

Factors contributing to the quality of the transition out of elite sports in Swiss,Danish, and Polish athletes

ObjectivesThe aim of this study was (a) to compare athletic retirement of former Swiss, Danish, and Polish athletes; and (b) to explore the influence of factors on the quality of the transition. Based on existing transitional models, we developed a working model to investigate the predictive power of commonly assumed resources and barriers related to the transition (Park, Lavallee, & Tod, 2013).Design and methodsFormer international elite athletes from Switzerland (n = 231), Denmark (n = 86), and Poland (n = 84) from 35 different sports completed an online questionnaire in their native language. Mean/proportional differences across countries were explored using ANOVAs and chi-square tests. For each sample, a multiple regression analysis was performed with 26 predictors on the transition quality, which was a component score of seven variables.Results and conclusionsMore differences were found among individual characteristics (e.g., educational level, athletic identity, confidence in skills), whereas athletes reported a similar pattern concerning retirement planning and voluntariness to end their career regardless of the context. The adaptation process following the career end was easiest for Swiss athletes and most difficult for Polish athletes. Results of the multiple regressions revealed both common resources (e.g., voluntariness) and barriers (e.g., athletic identity), but also factors that worked as resources in one context, but as barriers in another (e.g., high sportcareer income). We propose to avoid generalizations about resources and barriers influencing the transition, but to apply a culturally sensitive approach when studying athletic retirement in different contexts.     

Genetic and Environmental Influences on the Development and Stability of Executive Functions in Children of Preschool Age: A Longitudinal Study of Japanese Twins

Executive functions (EF) are an important predictor of later adaptive development. A number of environmental influences, such as parenting, have been suggested as important promoters of EF development. However, behavioural genetic research has demonstrated that many environmental influences could be affected by genetic influences. Therefore, it is important to consider genetic variations when investigating environmental influences on EF development in children. To date, few studies have used genetically informative designs to assess the etiology of EF development during the preschool years, a period of rapid development. As a result, it remains unclear how and to what extent the environmental influences that are not confounded by genetic influences affect EF development during this developmental period. The present study explored EF development during the preschool years using a longitudinal and genetically informative design and a non‐Western population. Japanese twins were visited at their homes and individually tested on EF measures at 24, 36, and 48 months of age. Phenotypic correlations and confirmatory factor analyses suggested that EF are less cohesive at 24 months of age and emerge as a common single factor at 36 and 48 months. Additionally, longitudinal and multivariate behavioural genetic analyses indicated that the EF developmental change during this period is promoted by both shared and nonshared environmental influences as well as genetic influences, while EF stability is brought about by shared environments. The present findings elucidated the etiology of EF development during the preschool years and confirmed that this period is an important transitional stage for EF development. Copyright © 2016 John Wiley & Sons, Ltd.     

Online attention modification for social anxiety disorder: replication of a randomized controlled trial

Social anxiety disorder (SAD) models posit vigilance for external social threat cues and exacerbated self-focused attention as key in disorder development and maintenance. Evidence indicates a modified dot-probe protocol may reduce symptoms of SAD; however, the efficacy when compared to a standard protocol and long-term maintenance of treatment gains remains unclear. Furthermore, the efficacy of such protocols on SAD-related constructs remains relatively unknown. The current investigation clarified these associations using a randomized control trial replicating and extending previous research. Participants with SAD (n = 113; 71% women) were randomized to complete a standard (i.e. control) or modified (i.e. active) dot-probe protocol consisting of 15-min sessions twice weekly for four weeks. Self-reported symptoms were measured at baseline, post-treatment, and 4-month and 8-month follow-ups. Hierarchical linear modeling indicated significant self-reported reductions in symptoms of social anxiety, fear of negative evaluation, trait anxiety, and depression, but no such reductions in fear of positive evaluation. Symptom changes did not differ based on condition and were maintained at 8-month follow-up. Attentional biases during the dot-probe task were not related to symptom change. Overall, our results replicate support for the efficacy of both protocols in reducing symptoms of SAD and specific related constructs, and suggest a role of exposure, expectancy, or practice effects, rather than attention modification, in effecting such reductions. The current results also support distinct relationships between fears of negative and positive evaluation and social anxiety. Further research focused on identifying the mechanisms of change in attention modification protocols appears warranted.     

Transdiagnostic group CBT for anxiety disorders: the unified protocol in mental health services

Comorbidity among the anxiety disorders is common and may negatively impact treatment outcome. Potentially, transdiagnostic cognitive-behavioral treatments (CBT) deal more effectively with comorbidity than standard CBT. The present study tested the effectiveness of The Unified Protocol (UP) applied to Mental Health Services. Pre-post-treatment effects were examined for psychiatric outpatients with anxiety disorders receiving UP treatment in groups. Forty-seven patients (mean-age = 34.1 (SD = 9.92), 77% females) with a principal diagnosis of anxiety were included. We found significant and clinically meaningful changes in the primary outcomes Clinical Global Impression Severity Scale (CGI-S; d = 1.36), Hamilton Anxiety Scale (HARS; d = .71), and WHO-5 Well-being Index (WHO-5; d = .54). Also, comorbid depressive symptoms and levels of positive and negative affect changed significantly after treatment. Patients with high levels of comorbidity profited as much as patients with less comorbidity; however, these patients had higher scores after treatment due to higher symptom burden at onset. Patients with comorbid depression profited more from treatment than patients without comorbid depression. The treatment effects found in the present study correspond to treatment effects of other TCBT studies, other UP group studies, and effectiveness studies on standard CBT for outpatients. The results indicate that the UP can be successfully applied to a MHS group setting, demonstrating positive effects on anxiety and depressive symptoms for even highly comorbid cases.     

The role of mother–child and teacher–child relationship on academic achievement

Robust findings have highlighted the importance of early cognitive abilities for academic performance. However, little is known about the role played by relational variables. In this longitudinal study, we examined children’s relationship with their mothers and teachers as predictors of later academic achievement. We addressed this issue following a group of 45 Italian children (29 boys) from the last year of preschool (mean age: five years and six months) until Year 4 of primary school (mean age: nine years and six months). Results showed that mother–child relationship at age 5 and teacher–child relationship at age 7 correlate with children’s academic achievement at age 9, controlling for early background and verbal abilities. Further analyses showed that teacher–child conflict partially mediates the relationship between early mother–child conflict and children’s later academic achievement. Mechanisms by which relational variables influence learning outcomes are discussed.     

Validation of Dating Violence Questionnarie-R (DVQ-R)

Background/Objective

Despite the growing interest in the study of dating violence, relatively few psychometrically sound instruments are available to researchers. To provide an instrument to researchers and professionals to assess victimization in dating relationships, with adequate psychometric properties. Method: Participants were 6,138 adolescents drawn from the general population, 25% of which were university students. Participants responded to the original Dating Violence Questionnaire (DVQ). Results: Confirmatory analyses results provided evidence of a clear factorial structure that was invariant through sex groups. The DVQ-R measures with 20 items five dimensions of abuse in affective interpersonal relationships of adolescents and youth: Detachment, Humiliation, Coercion, Physical and Sexual violence. Internal consistency indexes were adequate for both each one of the five dimensions as well as for the general scale. Conclusions: The DVQ-R is an useful assessment to be applied in adolescents and youth. Implications for research and intervention are discussed in light of the results obtained.     

Loudness counts: Interactions between loudness,number magnitude,and space

ATOM (a theory of magnitude) suggests that magnitude information of different formats (numbers, space, and time) is processed within a generalized magnitude network. In this study we investigated whether loudness, as a possible indicator of intensity and magnitude, interacts with the processing of numbers. Small and large numbers, spoken in a quiet and a loud voice, were simultaneously presented to the left and right ear (Experiments 1a and 1b). Participants judged whether the number presented to the left or right ear was louder or larger. Responses were faster when the smaller number was spoken in a quiet voice, and the larger number in a loud voice. Thus, task-irrelevant numerical information influenced the processing of loudness and vice versa. This bi-directional link was also confirmed by classical SNARC paradigms (spatial–numerical association of response codes; Experiments 2a–2c) when participants again judged the magnitude or loudness of separately presented stimuli. In contrast, no loudness–number association was found in a parity judgment task. Regular SNARC effects were found in the magnitude and parity judgment task, but not in the loudness judgment task. Instead, in the latter task, response side was associated with loudness. Possible explanations for these results are discussed.     

Parental Choices and the Prospect of Regret: An Alternative Account

Is the question ‘will you regret it if you do (not do) this?’ helpful when people face difficult life decisions, such as terminating a pregnancy if a disability is detected or deciding to become a parent? Despite the commonness of the question in daily life, several philosophers have argued lately against its usefulness. We reconstruct four arguments from recent literature on regret, transformative experience and the use of imagination in deliberation. After analysis of these arguments we conclude that the prospect of regret remains a useful deliberative heuristic, provided four conditions are fulfilled. If the prospect of (the absence of) regret is arrived at via reflection on one’s values, in a non-coercive context, when well-informed about factual circumstances, and in a process of self-commitment, the question of what one will regret is a helpful device to get in touch with one’s deepest concerns that give reasons to act in a particular way.