Is cognitive behavioural therapy effective in reducing suicidal ideation and behaviour when delivered face-to-face or via e-health? A systematic review and meta-analysis

Cognitive Behavioural Therapy (CBT) is a widely used psychotherapeutic intervention for suicide prevention despite its efficacy for suicide prevention in adults remaining ambiguous. Reluctance or inability to access face-to-face help suggests that e-health delivery may be a valuable resource for suicidal people. The aim of this study was to systematically review and conduct meta-analysis on research assessing the efficacy of CBT delivered via face-to-face and e-health for suicidal ideation and behaviour. A comprehensive literature search of MEDLINE, PsycINFO, Scopus, PubMed and The Cochrane Central Register of Controlled Trials was conducted. From 764 identified articles, 26 met the inclusion criteria for investigating CBT for suicidal ideation and behaviours in adult populations. Data were extracted on study characteristics and meta-analysis was performed where possible. There was a statistically significant, small to medium effect for face-to-face delivered CBT in reducing suicidal ideation and behaviour although there was significant heterogeneity between the included studies. CBT delivered via e-health was not found to be efficacious for reducing suicidal ideation and behaviour in adults though the number of studies reviewed was small.     

The interaction of distress tolerance and intolerance of uncertainty in the prediction of symptom reduction across CBT for social anxiety disorder

Distress tolerance (DT) and intolerance of uncertainty (IU) have been identified as transdiagnostic processes that predict symptom severity across a range of distinct anxiety disorders. However, the joint effect of these two variables on therapeutic outcome has not yet been examined. It is possible that DT and IU may both impact on treatment response to cognitive-behavioural therapy (CBT) in clients with anxiety, as clients with weak DT and strong IU may be less likely to engage in exposure and cognitive restructuring tasks across treatment due to their associated distress. The purpose of this study was to examine the interaction of DT and IU as predictors of post-treatment symptom severity and treatment response to group CBT in participants with primary DSM-IV-TR diagnosed social anxiety disorder (SAD). Participants (N = 95) with SAD completed 12 weeks of manualized group CBT. Results of multilevel longitudinal analysis demonstrated an interaction effect, such that lower DT and higher IU predicted higher SAD symptom severity across the course of therapy. The findings are discussed in terms of clinical implications for the disorder-specific and transdiagnostic treatment of anxiety disorders.     

Short- and long-term consequences in decision-making under risk: immediate feedback about long-term prospects benefits people tending to impulsive processing

Many decisions in everyday life involve weighing up immediate and expected future outcomes that may be conflictive. Yet, it is still unclear which cognitive functions may affect decision-making in such situations. We examined 150 healthy subjects using a new decision-making task that measures people’s ability at handling short- and long-term consequences under objective risk. Two task versions were developed to investigate the effects of feedback about long-term consequences on decision-making. One version includes feedback about changes in long-term prospects while the other does not. Both groups revealed that advantageous decision-making correlated with reasoning and working-memory abilities, however, no correlations with executive functions were found. The effect of feedback on decision-making performance was moderated by impulsivity and need for cognition. Our findings contribute to recent dual-system approaches for risky decision-making by showing that individuals with predispositions towards impulsive rather than reflective information processing could profit from feedback about long-term prospects.     

Risk behaviour and mental workload: Multimodal assessment techniques applied to motorbike riding simulation

We present data from an ongoing research project on the cognitive, emotional and neuropsychological basis of risk behaviour. The main aim of the project is to build a model of risk behaviour so that if we know certain cognitive, behavioural and emotional variables, we will be able to predict decisions made in the face of uncertainty and risk, with the final goal of designing programs for evaluating, preventing and controlling risk behaviour. The objective of the present study was to look for individual differences in hazard perception during a static riding simulation and their relationship with mental workload. We used a multidimensional methodology, including behavioural, subjective and physiological data. The behavioural measures were obtained in a static riding simulation during eight hazard situations. We evaluated whether eye activity measures correlated with cognitive workload and different types of risky behaviours. Eye movement parameters were measured using a video-based eye tracking system. We found that risk-prone individuals showed specific patterns of risky behaviours and that peak of saccadic velocity and subjective mental workload indexes were both reliable indicators of risk proneness. Mental workload was higher for participants showing attitudes to risk behaviours probably because of a lack of conscious awareness of specific cues indicating dangerous scenarios.     

The moderating effect of parental warmth on the association between spanking and child aggression: a longitudinal approach

Using data from the Early Head Start Research and Evaluation Study, this study analysed the stability of child aggressive behaviour beginning in infancy and tested whether spanking when the child was 36 months was associated with aggressive child behaviour among three ethnic groups and whether maternal warmth moderated the effect of spanking on aggressive behaviour in each ethnic group at 36 months, after controlling for earlier aggressive behaviour. Participants included 693 Hispanic parent–child dyads, 1013 African‐American dyads and 1086 Caucasian dyads who met qualifications for participation in the Early Head Start programme. Findings suggest that infant temperament was associated with aggressive behaviour at 24 and 36 months and that child aggression remained stable. Among the three ethnic groups, spanking was only associated with aggressive behaviour for children who had Caucasian mothers and maternal warmth did not moderate the effect of spanking on aggressive behaviour. Copyright © 2009 John Wiley & Sons, Ltd.     

The Effects of Social Identity and Perceived Autonomy Support on Health Behaviour Within the Theory of Planned Behaviour

The present study employed constructs from self-determination theory, social-identity theory, and the theory of planned behaviour to examine the combined effects that social identity and perceived autonomy support exerted on attitudes, intentions and health behaviour. A prospective design was employed measuring constructs from the theory of planned behaviour, group norms, group identification, and perceived autonomy support at baseline and physical activity behaviour 5 weeks later. Self-report questionnaires were administered to 231 pupils (male = 113, female = 118, M = 14.21 years, SD = .90). Hierarchical regression analysis demonstrated that group norms predicted participation in physical activities and attitudes, but only for participants who identified strongly with their group. Perceived autonomy support predicted attitudes, intentions and behaviour. The effects of perceived autonomy support and social-identity constructs were independent. It was concluded that both social identity and perceived autonomy support should be included in the theory of planned behaviour.     

The road to the unconscious self not taken: Discrepancies between self‐ and observer‐inferences about implicit dispositions from nonverbal behavioural cues

To what extent can individuals gain insight into their own or another person's implicit dispositions' We investigated whether self‐perceivers versus neutral observers can detect implicit dispositions from nonverbal behavioural cues contained in video feedback (cue validity) and whether these cues are in turn used as a valid basis for explicit dispositional inferences (cue utilization). Across three studies in the domains of extraversion and anxiety we consistently obtained reliable cue validity and cue utilization for neutral observers but not for self‐perceivers. An additional measure of state inferences in Study 3 showed that one reason for the lack of mediation in self‐perceivers is their reluctance to use their state inferences as a basis for more general trait inferences. We conclude that people have a ‘blind spot’ with respect to the nonverbal behavioural manifestations of their unconscious selves, even though neutral observers may readily detect and utilize this information for dispositional inferences. Copyright © 2009 John Wiley & Sons, Ltd.     

The role of familiarity in dietary development

The rise in inadequate and unhealthily diets in children has led investigations to examine the development of food preferences. This review outlines the ways in which children choose between foods made available to them and the subsequent shaping of their own habitual diet. Children are liable to form preferences to certain hedonic foods, and to exhibit neophobic reactions to the unfamiliar. Unfamiliar foods can elicit anxiety and suspicion. Trust and liking of a once novel food can be gained through exposure, increasing familiarity towards that food. This review examines: visual familiarity (awareness of foods within their environment); taste familiarity (knowledge and experience of the taste of foods); contextual familiarity (knowledge of how foods should be presented); and categorical familiarity (which family foods belong to). The influence of familiarity is also explained with regards to both positive and negative associative learning. These associations are influenced by the specific presentation and the social environment of a novel food. The potential benefits of understanding the nature of children’s learning and preference development for the promotion of healthy nutrition to both parent and child are discussed.     

Differentiating Type A behaviour and hyperactivity using observed motivation during a reaction time task

In light of the previously found overlap between Type A behaviour as measured by the Matthews Youth Test for Health (MYTH) and hyperactivity scales, the overall aim of this study was to clarify the standing of MYTH‐defined Type A behaviour relative to hyperactivity and Attention‐Deficit/Hyperactivity Disorder (ADHD), using observed task motivation and performance on a choice reaction‐time task, the Complex Reaction Time (CRT) measure. This study included 21 boys exhibiting Type A behaviour, 22 ADHD boys, 20 non‐clinically hyperactive boys, and 20 non‐hyperactive boys, between the ages of 6 and 13 years. It was proposed that a differentiation of constructs would be possible using observed task motivation if the MYTH were a discriminantly valid measure of Type A behaviour. Results showed that the MYTH‐defined Type A group differed from the clinically diagnosed ADHD group, although it was markedly similar to the non‐clinical hyperactive group, displaying comparable CRT performance and low level of task motivation. Type A behaviour correlated to CRT performance and task motivation in a way which was conceptually more indicative of hyperactivity than of Type A behaviour, which questions the validity of the MYTH as a measure of the Type A construct. The MYTH Impatience subscale was found to be particularly impure with regard to hyperactivity. Copyright © 2003 John Wiley & Sons, Ltd.     

Relationships between personality, attitudes and dietary behaviour in a group of Scottish adolescents

Dietary behaviours, dietary attitudes, dietary knowledge and personality were surveyed in a group of 451 Scottish schoolchildren aged 11–15 years. A factor analysis of the behaviour items gave a three-factor structure with factors designated Healthy Eating, Unhealthy Eating and Health Habits. A general healthy vs. unhealthy eating factor was also extracted. A factor analysis of the attitude statements gave factors designated Pickiness, Neophobia and Food Interest. Dietary knowledge was found to be positively correlated with Healthy Eating score and negatively correlated with Unhealthy Eating score. The personality trait of Psychoticism was positively correlated with Unhealthy Eating score and negatively correlated with dietary knowledge, whilst Neuroticism was significantly negatively correlated with Healthy Eating and Health Habits and significantly positively correlated with Pickiness and Neophobia. Gender and socio-economic status differences in behaviour and attitude factor scores are also reported.