Cognitive style and depressive symptoms in elderly people - Extending the empirical evidence for the cognitive vulnerability-stress hypothesis

Introduction

Depression is common in older people and its identification and treatment has been highlighted as one of the major challenges in an ageing world. Poor physical and cognitive health, bereavement, and prior depression are important risk factors for depression in elderly people. Attributional or cognitive style has been identified as a risk factor for depression in children, adolescents and younger adults but its relevance for depression and mood in elderly people has not been investigated in the context of other risk factors.

Method

Sixty-four older adults from an ‘extra care’ living scheme (aged 59-97) were recruited for a 6-week prospective study to examine the relationships between cognitive style and depressive symptoms.

Results

Regression analyses revealed that, when other risk factors were controlled for, cognitive style and its interaction with stress predicted changes in depressive symptoms, therefore partially replicating prior research.

Conclusion

Cognitive-stress-vulnerability models also apply to elderly populations, but may be rather predictive of changes in depression when facing lower levels of stress.     

Transdiagnostic Internet treatment for anxiety disorders: A randomized controlled trial

Clinician-guided Internet-based cognitive behavioural therapy (iCBT) programs are clinically effective at treating specific anxiety disorders. The present study examined the efficacy of a transdiagnostic Internet-based cognitive behavioural treatment (iCBT) program to treat more than one anxiety disorder within the same program (the Anxiety Program). Eighty six individuals meeting diagnostic criteria for generalized anxiety disorder (GAD), panic disorder, and/or social phobia were randomly assigned to a treatment group, or to a waitlist control group. Treatment consisted of CBT based online educational lessons and homework assignments, weekly email or telephone contact from a clinical psychologist, access to a moderated online discussion forum, and automated emails. An intention-to-treat model using the baseline-observation-carried-forward principle was employed for data analyses. Seventy-five percent of treatment group participants completed all 6 lessons within the 8 week program. Post-treatment data was collected from 38/40 treatment group and 38/38 control group participants, and 3-month follow-up data was collected from 32/40 treatment group participants. Relative to controls, treatment group participants reported significantly reduced symptoms of anxiety as measured by the Generalized Anxiety Disorder - 7 Item, Social Phobia Screening Questionnaire, and the Panic Disorder Severity Rating Scale - Self Report Scale, but not on the Penn State Worry Questionnaire, with corresponding between-groups effect sizes (Cohen’s d) at post-treatment of 0.78, 0.43, 0.43, and 0.20, respectively. The clinician spent a total mean time of 46 min per person over the program, participants rated the procedure as moderately acceptable, and gains were sustained at follow-up. Modifications to the Anxiety program, based on post-treatment feedback from treatment group participants, were associated with improved outcomes in the control group. These results indicate that transdiagnostic programs for anxiety disorders may be successfully administered via the Internet.     

How does mindfulness-based cognitive therapy work?

Mindfulness-based cognitive therapy (MBCT) is an efficacious psychosocial intervention for recurrent depression ( [Kuyken et?al., 2008], [Ma and Teasdale, 2004] and [Teasdale et?al., 2000]). To date, no compelling research addresses MBCT’s mechanisms of change. This study determines whether MBCT’s treatment effects are mediated by enhancement of mindfulness and self-compassion across treatment, and/or by alterations in post-treatment cognitive reactivity. The study was embedded in a randomized controlled trial comparing MBCT with maintenance antidepressants (mADM) with 15-month follow-up (Kuyken et al., 2008). Mindfulness and self-compassion were assessed before and after MBCT treatment (or at equivalent time points in the mADM group). Post-treatment reactivity was assessed one month after the MBCT group sessions or at the equivalent time point in the mADM group. One hundred and twenty-three patients with ≥3 prior depressive episodes, and successfully treated with antidepressants, were randomized either to mADM or MBCT. The MBCT arm involved participation in MBCT, a group-based psychosocial intervention that teaches mindfulness skills, and discontinuation of ADM. The mADM arm involved maintenance on a therapeutic ADM dose for the duration of follow-up. Interviewer-administered outcome measures assessed depressive symptoms and relapse/recurrence across 15-month follow-up. Mindfulness and self-compassion were measured using self-report questionnaire. Cognitive reactivity was operationalized as change in depressive thinking during a laboratory mood induction.MBCT’s effects were mediated by enhancement of mindfulness and self-compassion across treatment. MBCT also changed the nature of the relationship between post-treatment cognitive reactivity and outcome. Greater reactivity predicted worse outcome for mADM participants but this relationship was not evident in the MBCT group.MBCT’s treatment effects are mediated by augmented self-compassion and mindfulness, along with a decoupling of the relationship between reactivity of depressive thinking and poor outcome. This decoupling is associated with the cultivation of self-compassion across treatment.     

The effects of mindfulness-based cognitive therapy on recurrence of depressive episodes, mental health and quality of life: A randomized controlled study

Depression is characterized by a large risk of relapse/recurrence. Mindfulness-based cognitive therapy (MBCT) is a recent non-drug psychotherapeutic intervention to prevent future depressive relapse/recurrence in remitted/recovered depressed patients. In this randomized controlled trial, the authors investigated the effects of MBCT on the relapse in depression and the time to first relapse since study participation, as well as on several mood states and the quality of life of the patients. 106 recovered depressed patients with a history of at least 3 depressive episodes continued either with their treatment as usual (TAU) or received MBCT in addition to TAU. The efficacy of MBCT was assessed over a study period of 56 weeks. At the end of the study period relapse/recurrence was significantly reduced and the time until first relapse increased in the MBCT plus TAU condition in comparison with TAU alone. The MBCT plus TAU group also showed a significant reduction in both short and longer-term depressive mood and better mood states and quality of the life. For patients with a history of at least three depressive episodes who are not acutely depressed, MBCT, added to TAU, may play an important role in the domain of relapse prevention in depression.     

Psychosocial correlates of depressive rumination

The study examined the relationship between brooding, the maladaptive sub-component of depressive rumination, an important cognitive mechanism implicated in the aetiology of depression, and a range of depressogenic psychosocial factors, including insecure attachment styles and maladaptive interpersonal behaviours. It was hypothesised that brooding (but not the more adaptive reflection component) is associated with an attachment pattern characterised by fear of rejection, and an interpersonal style characterised by submissiveness. Currently depressed (n = 29), previously depressed (n = 42) and never-depressed (n = 32) adults completed self-report measures assessing depressive symptoms, rumination (brooding and reflection), attachment orientation and maladaptive interpersonal behaviours. The study hypotheses were partially supported: After controlling for gender and depressive symptoms, brooding was significantly associated with one indicator of underlying rejection concerns (rejection sensitivity, p = .05), but was not associated with another indicator of underlying rejection concerns (anxious attachment style) or with avoidant attachment style. After controlling for depressive symptoms, brooding was uniquely associated with the submissive interpersonal style (p < .01). Brooding was not correlated with needy or cold interpersonal styles after controlling for depressive symptoms.     

FEELING WITHOUT THINKING: LESSONS FROM THE ANCIENTS ON EMOTION AND VIRTUE-ACQUISITION

Abstract: By briefly sketching some important ancient accounts of the connections between psychology and moral education, I hope to illuminate the significance of the contemporary debate on the nature of emotion and to reveal its stakes. I begin the essay with a brief discussion of intellectualism in Socrates and the Stoics, and Plato's and Posidonius's respective attacks against it. Next, I examine the two current leading philosophical accounts of emotion: the cognitive theory and the noncognitive theory. I maintain that the noncognitive theory better explains human behavior and experience and has more empirical support than the cognitive theory. In the third section of the essay I argue that recent empirical research on emotional contagion and mirroring processes provides important new evidence for the noncognitive theory. In the final section, I draw some preliminary conclusions about moral education and the acquisition of virtue.     

Modeling and estimating recall processing capacity: Sensitivity and diagnostic utility in application to mild cognitive impairment

We investigate the potential for using latency-based measures of retrieval processing capacity to assess changes in performance specific to individuals with mild cognitive impairment (MCI), a reliable precursor state to Alzheimer’s Disease. Use of these capacity measures is motivated in part by exploration of the effects of atrophy on a computational model of a basic hippocampal circuit. We use this model to suggest that capacity may be a more sensitive indicator of the underlying atrophy than speed of processing, and test this hypothesis by adapting a standard behavioral measure of memory (the free and cued selective reminding test, FCSRT) to allow for the collection of cued recall latencies. Participants were drawn from five groups: college-aged, middle-aged, healthy elderly, those with a diagnosis of MCI, and a sample of MCI control participants. The measure of capacity is shown to offer increased classificatory sensitivity relative to the standard behavioral measures, and is also shown to be the behavioral measure that correlated most strongly with hippocampal volume.     

Chess as a Behavioral Model for Cognitive Skill Research: Review of Blindfold Chess by Eliot Hearst and John Knott

This multifaceted work on chess played without sight of the pieces is a sophisticated psychologist's examination of this topic and of chess skill in general, including a detailed and comprehensive historical account. This review builds on Hearst and Knott's assertion that chess can provide a uniquely useful model for research on several issues in the area of cognitive skill and imagery. A key issue is the relationship between viewing a stimulus and mental imagery in the light of blindfold chess masters' consistent reports that they do not use or have images. This review also proposes a methodology for measuring and quantifying an individual's skill shortfall from a theoretical maximum. This methodology, based on a 1951 proposal by Claude Shannon, is applicable to any choice situation in which all the available choices are known. The proposed “Proficiency” measure reflects the equivalent number of “yes—no” questions that would have been required to arrive at a best choice, considering also the time consumed. As the measure provides a valid and nonarbitrary way to compare different skills and the effects of different independent variables on a given skill, it may have a wide range of applications in cognitive skill research, skill training, and education.     

当前阅读研究中眼动指标述评

文章重点介绍了阅读研究中常用的眼动指标,它们包括注视时间、眼跳、回视和瞳孔直径等,从字和区域这两个方面探讨了这些眼动指标所反映的认知加工过程,以及选择这些指标时应该注意的问题。最后对眼动指标的选择和使用等问题提出了几点看法。     

监狱警察应对方式与心理健康水平研究

本文通过对重庆市监狱警察应对方式和心理健康水平的抽调研究,发现调查对象倾向于采取成熟的应对方式,且其心理健康水平优于普通人群,在对应对方式有效性的评价（认识）、采取的应对方式（行为）和心理健康水平（结果）三者之间存在一致性;男女狱警在应对方式和心理健康水平方面都存在一些差异,且差异显著。这提示我们在进行应对方式干预时要注意男女狱警不同的两性特征和角色期望。