Treating Procrastination Using Cognitive Behavior Therapy: A Pragmatic Randomized Controlled Trial Comparing Treatment Delivered via the Internet or in Groups

Procrastination is a common problem among university students, with at least half of the population reporting great difficulties initiating or completing tasks and assignments. Procrastination can have a negative impact on course grades and the ability to achieve a university degree, but can also lead to psychological distress. Cognitive behavior therapy (CBT) is believed to reduce procrastination, but few studies have investigated its effectiveness in a regular clinical setting. The current study explored its effects using a pragmatic randomized controlled trial comparing treatment delivered during 8 weeks as self-guided CBT via the Internet (ICBT) or as group CBT. In total, 92 university students with severe procrastination were included in the study (registered as a clinical trial on Clinicaltrials.gov: NCT02112383). Outcome measures on procrastination, depression, anxiety, and well-being were distributed at pre- and posttreatment as well as 6-month follow-up. An outcome measure of procrastination was administered weekly. Linear mixed and fixed effects models were calculated, along with improvement and deterioration rates. The results showed large within-group effect sizes on procrastination, Cohen’s d of 1.29 for ICBT, 95% Confidence Interval (CI) [0.81, 1.74], and d of 1.24 for group CBT, 95% CI [0.76, 1.70], and small to moderate benefits for depression, anxiety, and well-being. In total, 33.7% were regarded as improved at posttreatment and 46.7% at follow-up. No differences between conditions were observed after the treatment period, however, participants in group CBT continued or maintained their improvement at follow-up, while participants in self-guided ICBT showed some signs of deterioration. The findings from the current study suggest that CBT might be an effective treatment for those struggling with severe procrastination, but that a group format may be better for some to sustain their benefits over time and that the clinical significance of the results need to be investigated further.     

Improved Parent Cognitions Relate to Immediate and Follow-Up Treatment Outcomes for Children With ADHD-Predominantly Inattentive Presentation

We investigated treatment effects on parenting self-efficacy and parent cognitive errors, and whether these parent cognitions are related to short- and long-term outcomes in parenting behaviors in psychosocial treatment for youth with attention-deficit/hyperactivity disorder, predominantly inattentive presentation (ADHD-I). In a randomized controlled trial across two sites (University of California, San Francisco, and University of California, Berkeley), 199 children between the ages of 7 and 11 were randomized to the Child Life and Attention Skills (CLAS; n = 74) program, parent-focused treatment (PFT; n = 74), or treatment as usual (TAU; n = 51). Parents reported on self-efficacy, cognitive errors, positive parenting, and negative parenting prior to treatment, immediately after treatment, and in the next school year at follow-up. Compared to TAU, CLAS and PFT had higher posttreatment parenting self-efficacy, and CLAS alone had lower posttreatment parent cognitive errors. At follow-up, only CLAS had improved parent cognitive errors compared to TAU. No other between-group differences were found in parenting self-efficacy or cognitive errors. Improved parenting self-efficacy was associated with improved posttreatment negative parenting outcomes for PFT and CLAS, and improved parent cognitive errors were also related to improvements in positive and negative posttreatment parenting outcomes for CLAS. Posttreatment parenting self-efficacy mediated follow-up negative parenting outcomes for CLAS and posttreatment parent cognitive errors mediated improved follow-up positive and negative parenting outcomes for CLAS. PFT and CLAS led to enhanced parenting self-efficacy, and CLAS appears especially robust in improving parent cognitive errors both in the short and long term. Pathways provide support for the possibility of parent cognitions as mediators of treatment effects on parenting; clinical focus on such cognitions may be useful.     

Cognitive diagnosis modelling incorporating item response times

To provide more refined diagnostic feedback with collateral information in item response times (RTs), this study proposed joint modelling of attributes and response speed using item responses and RTs simultaneously for cognitive diagnosis. For illustration, an extended deterministic input, noisy ‘and’ gate (DINA) model was proposed for joint modelling of responses and RTs. Model parameter estimation was explored using the Bayesian Markov chain Monte Carlo (MCMC) method. The PISA 2012 computer-based mathematics data were analysed first. These real data estimates were treated as true values in a subsequent simulation study. A follow-up simulation study with ideal testing conditions was conducted as well to further evaluate model parameter recovery. The results indicated that model parameters could be well recovered using the MCMC approach. Further, incorporating RTs into the DINA model would improve attribute and profile correct classification rates and result in more accurate and precise estimation of the model parameters.     

Two-Stage maximum likelihood estimation in the misspecified restricted latent class model

The maximum likelihood classification rule is a standard method to classify examinee attribute profiles in cognitive diagnosis models (CDMs). Its asymptotic behaviour is well understood when the model is assumed to be correct, but has not been explored in the case of misspecified latent class models. This paper investigates the asymptotic behaviour of a two-stage maximum likelihood classifier under a misspecified CDM. The analysis is conducted in a general restricted latent class model framework addressing all types of CDMs. Sufficient conditions are proposed under which a consistent classification can be obtained by using a misspecified model. Discussions are also provided on the inconsistency of classification under certain model misspecification scenarios. Simulation studies and a real data application are conducted to illustrate these results. Our findings can provide some guidelines as to when a misspecified simple model or a general model can be used to provide a good classification result.     

Verbal instructions targeting valence alter negative conditional stimulus evaluations (but do not affect reinstatement rates)

Negative conditional stimulus (CS) valence acquired during fear conditioning may enhance fear relapse and is difficult to remove as it extinguishes slowly and does not respond to the instruction that unconditional stimulus (US) presentations will cease. We examined whether instructions targeting CS valence would be more effective. In Experiment 1, an image of one person (CS+) was paired with an aversive US, while another (CS?) was presented alone. After acquisition, participants were given positive information about the CS+ poser and negative information about the CS? poser. Instructions reversed the pattern of differential CS valence present during acquisition and eliminated differential electrodermal responding. In Experiment 2, we compared positive and negative CS revaluation by providing positive/negative information about the CS+ and neutral information about CS?. After positive revaluation, differential valence was removed and differential electrodermal responding remained intact. After negative revaluation, differential valence was strengthened and differential electrodermal responding was eliminated. Unexpectedly, the instructions did not affect the reinstatement of differential electrodermal responding.     

Memory rehabilitation for older adults: preserving independent living / Rehabilitación de la memoria para adultos mayores: preservación de la autonomía de vida

Abstract

Episodic memory problems are the hallmark of cognitive ageing in normal elderly people. Learning of new material is worse in pathological cognitive ageing, such as dementia and its preliminary states (mild cognitive impairment). Because episodic learning is crucial to preserve independent living in the elderly, rehabilitation programmes for everyday memory problems are welcomed. The scope of scientific interest has switched from treatment to prevention. We claim that lifestyle interventions are the most direct way to preserve cognition. We summarize evidence for changes in nutrition and exercise. In addition, psychological interventions for elderly people with normal or pathological cognitive ageing are available. Recent meta-analyses found lacking evidence of transfer to everyday life and long-term effects. We critically assess these meta-analyses. We propose theoretically derived experimental interventions relying on spared learning mechanisms. As an example we report visual-imagery training showing positive effects in a randomized control trial, using individual memory diaries on memory improvement.     

Specificity of relations between adolescents’ cognitive emotion regulation strategies and symptoms of depression and anxiety

ABSTRACT

The aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame (only girls), positive reappraisal, and positive refocusing (the latter two inversely) were uniquely (and significantly) associated with depression symptoms; and after controlling for comorbid depression symptoms, catastrophising and other-blame were uniquely related to anxiety symptoms. The results supported the cognitive content-specificity model, in which anxiety is supposed to be uniquely characterised by thoughts concerning the overestimation of threats and harm, and depression is supposed to be uniquely characterised by negative evaluations of self, and of past and future events.     

Cognitive reactivity as outcome and working mechanism of mindfulness-based cognitive therapy for recurrently depressed patients in remission

Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N?=?115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d?=?.51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.     

Religious versus reflective priming and susceptibility to the conjunction fallacy

The effect of religious priming has been studied in relation to a number of variables, most extensively with prosocial behavior. The effects of priming on cognitive domains, however, are relatively understudied. The present study examined the effects of religious priming, compared with reflective and neutral priming, on the conjunction fallacy. Participants were randomly assigned to 1 of the 3 priming conditions. Priming was presented through the scrambled sentence task in which participants were required to rearrange words of a religious (e.g., pray), reflective (e.g., reason), or neutral (e.g., paper) content. The conjunction fallacy was measured by a task containing 1 problem. Results indicated that those undergoing the religious prime were significantly more likely to commit the conjunction fallacy compared with those in the reflective priming group. Situations in which reasoning is integral may benefit from knowing the immediate effects of religious versus reflective stimuli in the environment.     

The relations between cognitive ability and personality: Convergent results across measures

Several studies have investigated the relations between cognitive ability and Big Five personality constructs. The present study extended previous research by (a) examining these relationships in large samples (total N = 120,014), (b) including several measures of cognitive ability and personality, (c) examining both domain and facet-level personality scores, (d) expanding the personality domains studied to include Machiavellianism, and (e) correcting the observed correlations for range restriction and reliability to provide a better statistical estimate of the relations between the cognitive and personality scores and constructs. Results were consistent with prior research showing a positive relationship between cognitive ability and Openness and negative relationships between cognitive ability and Neuroticism and Conscientiousness. Negative relations between cognitive ability and Extraversion and Agreeableness also were observed. Machiavellianism, not part of the Big Five was found to have a positive correlation with cognitive ability. Of particular interest was the finding that the relations between cognitive ability and personality were affected by the specific content of the cognitive and personality measures. Cognitive measures with verbal content were more strongly correlated with personality than were cognitive measures with math or nonverbal content for all of the samples. Also, there was considerable variability in the cognitive-personality correlations for the facets underlying each personality domain. The variability in correlations at the facet-level implies that cognitive-personality relationships at the domain-level will vary as a function of the specific content of the cognitive and personality measures. Overall, the results provide support for cognitive-personality association at the measurement level.