Rethinking safety behaviors in insomnia: examining the perceived utility of sleep-related safety behaviors

Harvey's cognitive model of insomnia (2002a) proposes that sleep-related safety behaviors play a central role in the maintenance of insomnia because such maladaptive coping strategies are thought to reinforce threat-based appraisals of the likelihood and consequences of poor sleep. Research to date has assessed the frequency of safety behavior use in those with insomnia only; however, in addition to the frequency of occurrence, the function of safety behaviors (i.e., a belief that they will prevent a feared outcome from occurring), may be an important consideration. The purpose of this study was to examine sleep-related safety behaviors based on an expanded theoretical understanding of such behaviors across psychological disorders; that is, by examining both their frequency and perceived utility. Undergraduate students (N = 376) completed an online survey about their sleep, mood, and use of sleep-related safety behaviors. Insomnia severity was associated with a greater perceived need to use safety behaviors (i.e., utility) but not with frequency of safety behavior use. Higher perceived utility of safety behaviors was also associated with unhelpful beliefs about sleep, fear and avoidance of fatigue, and both general and sleep-specific helplessness. These results suggest that these behaviors and the associated underlying maladaptive beliefs may be important targets in cognitive behavioral therapy for insomnia. The current study extends the existing literature and refines the concept of safety behaviors in insomnia to include both the function and frequency of these behaviors.     

The effectiveness of a biblio-based support group for hoarding disorder

Compulsive hoarding is characterized by the acquisition of, and failure to discard, a large number of possessions and clutter that prevents the use of living spaces as intended. Current successful treatments such as individual and group cognitive-behavioral therapy are lengthy and costly, requiring a time commitment ranging from four to twelve months, trained clinicians to administer treatment, and multiple home visits. Nonprofessional interventions may provide a cost-effective pre-treatment, adjunct, or alternative for individuals who want to work on hoarding problems but are unable or unwilling to engage in treatment. The purpose of the present study was to investigate the effectiveness of an innovative program consisting of a 13-session non-professionally facilitated biblio-based, action-oriented support group using Tolin, Frost, and Steketee’s (2007b) self-help book. In study 1, seventeen self-identified hoarding participants experienced significant decreases in clutter, difficulty discarding, and excessive acquisition from pre-treatment to post-treatment, with reductions evident at mid-treatment. Study 2 replicated the findings of study 1 using interview and observational measures taken in participants’ homes. These findings suggest that a facilitated biblio-based group may be a promising intervention for hoarding disorder.     

How to Cook Rice: A Review of Ingredients for Teaching anti‐Prejudice

There is a pressing need to address prejudice, racism, and discrimination against marginalised groups in Australia. This involves change from the structural to the individual level. In this article, we discuss the merits of individual anti‐prejudice mechanisms within the Australian context. First, we expand on nine mechanisms described in a previous paper and then review five new mechanisms. We conclude that while some mechanisms are likely to be useful regardless of location, others need to be tailored to the local context. We also conclude that effective interventions need to utilise multiple mechanisms. It is hoped that the synthesis of the different mechanisms provided here will assist anti‐prejudice researchers, practitioners, and policymakers striving to improve relations among different groups in our society.     

Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation

We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen’s d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.     

A test of written emotional disclosure as an intervention for posttraumatic stress disorder

This study examined the efficacy of the written emotional disclosure (WED) procedure with a sample of young adults who met diagnostic criteria for posttraumatic stress disorder (PTSD). Participants were randomly assigned to either WED or a control writing condition and were assessed at baseline and one month following the writing sessions. During each writing session, participants’ heart rate was recorded; participants also provided self-report ratings of emotional responding. Findings indicated no significant group differences for PTSD and depression symptom severity at follow-up assessment. Relative to control participants, WED participants displayed significantly greater heart rate activity and reported greater emotional responding during the first writing session; however, no reduction in emotional responding occurred for either condition from the first to the last writing session. Taken together, these findings indicate that WED may not be an efficacious intervention for PTSD. Suggestions are made for future work in this area.     

Emotion dysregulation and adolescent psychopathology: a prospective study

Background

Emotion regulation deficits have been consistently linked to psychopathology in cross-sectional studies. However, the direction of the relationship between emotion regulation and psychopathology is unclear. This study examined the longitudinal and reciprocal relationships between emotion regulation deficits and psychopathology in adolescents.

Methods

Emotion dysregulation and symptomatology (depression, anxiety, aggressive behavior, and eating pathology) were assessed in a large, diverse sample of adolescents (N = 1065) at two time points separated by seven months. Structural equation modeling was used to examine the longitudinal and reciprocal relationships between emotion dysregulation and symptoms of psychopathology.

Results

The three distinct emotion processes examined here (emotional understanding, dysregulated expression of sadness and anger, and ruminative responses to distress) formed a unitary latent emotion dysregulation factor. Emotion dysregulation predicted increases in anxiety symptoms, aggressive behavior, and eating pathology after controlling for baseline symptoms but did not predict depressive symptoms. In contrast, none of the four types of psychopathology predicted increases in emotion dysregulation after controlling for baseline emotion dysregulation.

Conclusions

Emotion dysregulation appears to be an important transdiagnostic factor that increases risk for a wide range of psychopathology outcomes in adolescence. These results suggest targets for preventive interventions during this developmental period of risk.     

Panel: What could be Jungian about Human Rights work?

The question of whether Jungian analysts should move beyond the consulting room to engage with mental health issues that pertain to the collective is the focus of this paper. Two narratives are presented: one from the view point of a psychiatrist in Occupied Palestine, the other from the conflicted situation which faces an Israeli analyst. Despite the strong ambivalence that is experienced on both sides, there is a willingness to meet and to take a standpoint without necessarily coming to a resolution. A third position is offered by describing experiences from the South African perspective. The African notion of Ubuntu is offered as a moral entry point that states that community goes beyond one's own; from this point of view, Jungian analysts can do no other than to act.     

The development of the still-face effect: Mothers do matter

The Face-to-Face Still-Face paradigm (FFSF) has been used to investigate how infants react to stressful events. However, there is little developmental data on the FFSF effect, and whether it connects to a specific relationship (e.g., to a mother versus a stranger). This prospective longitudinal study aims to evaluate developmental changes in infant reaction to the FFSF presented by the mother or a stranger at 2, 4, 6, and 8 months of age (n = 39). Results show that infant negativity was expressed less in relation to a stranger, the identity effect. Results further suggest that from 6 to 8 months of age, stranger induced protest flattens out; whereas mother induced protest decreases. The results are discussed in relation to different theories regarding infant responsiveness.     

Chance operations in training: a participatory format for introducing dialogical family therapy

Presenting dialogical approaches to therapy calls for training approaches that are themselves participatory and dialogical. The use of chance operations is one way of enhancing an interactive and co‐constructive learning process.     

Prenatal depression effects and interventions: A review

This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded by low serotonin and low dopamine levels which in themselves could contribute to non-optimal pregnancy outcomes. The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women's partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce prenatal depression and cortisol in the women and prematurity and low birthweight in their infants.