The importance of assessing treatment integrity: An example in the anxiety disorders

One purpose of this investigation was to examine the importance of assessing treatment integrity in a study evaluating a treatment for specific anxiety disorders. Three subjects, two social phobics and one simple phobic, received self-instruction training (Phase I) followed by exposure and self-instruction training (Phase II) in a multiple baseline across subjects design. All subjects were assessed during a pretreatment baseline and throughout treatment using measures of treatment integrity and measures of change in phobic severity. Improvement took place at different times for different subjects. Measures of treatment integrity, which consisted of monitoring of self-statements as well as practice outside the session, indicated that treatment was not always received as intended and that improvement was correlated with practice. The usefulness of measures of treatment integrity in both clinical and research settings is highlighted.     

自闭症和智力障碍儿童行为问题与父母焦虑的关系:育儿压力的中介作用与领悟社会支持的调节作用

为探讨自闭症和智力障碍儿童行为问题与其父母焦虑的关系及其内在作用机制,研究采用问卷法对1023名自闭症和智力障碍儿童父母进行调查。结果表明：(1)自闭症和智力障碍儿童行为问题对父母焦虑具有正向预测作用;(2)育儿压力在儿童行为问题和父母焦虑间起中介作用;(3)儿童行为问题与育儿压力的关系受到领悟社会支持水平的调节,调节作用只在智力障碍儿童父母群体中显著。研究结果有助于揭示自闭症和智力障碍儿童行为问题对父母焦虑的影响及作用机制,对改善自闭症和智力障碍儿童父母育儿压力与焦虑具有一定指导意义。     

Does authenticity always breed mental health? A cross-cultural comparison between the United States and China

Numerous studies on Western cultures have suggested a strong linkage between authenticity and mental health. However, little is known about whether such an association can be generalized to Eastern cultures. This study aimed to conduct a cross-cultural comparison on the association between three dimensions of authenticity (authentic living, self-alienation, and accepting external influence) and two factors of mental health (negative and positive) across Western and Eastern cultures. Measurement invariance tests were carried out and multigroup structural regression models developed on two college samples from the US (n = 392) and China (n = 281). Results suggested that the associations between authenticity and the negative factor of mental health were consistent across cultures, where both self-alienation and accepting external influence were positively associated with anxiety. However, the associations between authenticity and the positive factor of mental health were different in the US and Chinese samples. Specifically, both authentic living and accepting external influence were significantly associated with life satisfaction in the US sample but not in the Chinese sample. Findings stress that having a nondistorted perception of the true self is critically related to lower levels of anxiety across cultures and highlighted the need to identify culture-specific promotive factors for life satisfaction.     

Worldviews about change: Their structure and their implications for understanding responses to sustainability,technology, and political change

People hold different perspectives about how they think the world is changing or should change. We examined five of these “worldviews” about change: Progress, Golden Age, Endless Cycle, Maintenance, and Balance. In Studies 1–4 (total N = 2733) we established reliable measures of each change worldview, and showed how these help explain when people will support or oppose social change in contexts spanning sustainability, technological innovations, and political elections. In mapping out these relationships we identify how the importance of different change worldviews varies across contexts, with Balance most critical for understanding support for sustainability, Progress/Golden Age important for understanding responses to innovations, and Golden Age uniquely important for preferring Trump/Republicans in the 2016 US election. These relationships were independent of prominent individual differences (e.g., values, political orientation for elections) or context-specific factors (e.g., self-reported innovativeness for responses to innovations). Study 5 (N = 2140) examined generalizability in 10 countries/regions spanning five continents, establishing that these worldviews exhibited metric invariance, but with country/region differences in how change worldviews were related to support for sustainability. These findings show that change worldviews can act as a general “lens” people use to help determine whether to support or oppose social change.     

“It's wrong to relax,you have to be on the go,go, go,all the time”: Emotional transformation in a case of emotion-focused therapy for generalised anxiety disorder

Generalised anxiety disorder (GAD) is a highly prevalent, chronic and impairing disorder. The aim of this study was to qualitatively describe the transformation in emotional processing across 16 sessions of a successful emotion-focused therapy (EFT) treatment for GAD. A theoretical framework derived from the EFT model of in-session emotional transformation proposed by Pascual-Leone and Greenberg was used as the basis for qualitative analysis. Additionally, the Classification of Affective Meaning States, the Client-Expressed Arousal Scale-III and the Client Emotional Productivity Scale-Revised were utilised by observer–raters to classify moment-by-moment shifts in client affective-meaning states, emotional arousal and emotional productivity. Results supported the emotion transformation model. The client presented in a state of poorly differentiated but highly aroused distress provoked by identifiable interpersonal and intrapersonal triggers. Emotional and behavioural avoidance provoked by fear of pain was evident. Accessing core pain and responding to attendant needs with compassion and protective anger was shown to facilitate the higher order emotional processing states of grief, relief and agency. Implications are proposed, including that addressing core emotional vulnerability may be a critical intervention in the successful treatment of GAD.     

Examining Safety Behavior Subtypes Across Distinct Social Contexts in Social Anxiety Disorder and Major Depression

People with social anxiety disorder (SAD) use different types of safety behaviors that have been classified as avoidance vs. impression management. The current study investigated differences in safety behavior subtype use in 132 individuals with principal diagnoses of social anxiety disorder (SAD, n = 69), major depressive disorder (MDD, n = 30), and nonpatient controls (n = 33) across two social contexts: an interpersonal relationship-building task (social affiliation) and a speech task (social performance). We examined whether diagnostic groups differed in safety behavior subtype use and whether group differences varied by social context. We also explored relationships between avoidance and impression management safety behaviors, respectively, and positive and negative valence affective and behavioral outcomes within the social affiliation and social performance contexts. Safety behavior use varied by diagnosis (SAD > MDD > nonpatient controls). The effect of diagnosis on impression management safety behavior use depended on social context: use was comparable for the principal SAD and MDD groups in the social performance context, whereas the SAD group used more impression management safety behaviors than the MDD group in the social affiliation context. Greater use of avoidance safety behaviors related to higher negative affect and anxious behaviors, and lower positive affect and approach behaviors across contexts. Impression management safety behaviors were most strongly associated with higher positive affect and approach behaviors within the social performance context. These findings underscore the potential value of assessing safety behavior subtypes across different contexts and within major depression, in addition to SAD.