Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control

We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = –4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.     

Different answers to different audiences: effects of social context on the accuracy-informativeness trade-off

Research on conversational exchanges shows that people attempt to optimise their responses’ relevance when they definitely know the correct answer (e.g., “What time is it?”). However, such certainty is often unavailable while speakers may still be under social pressure to provide an answer. We investigated how social context influences the informativeness level when answering questions under uncertainty. In three experiments, participants answered difficult general-knowledge questions placed in different social contexts (formal vs. informal). Participants generated their answers, then they were presented with a given context, and decided on the number of alternative responses they wanted to provide (single, with one alternative vs. plural, with several alternatives) and whether the answer should be reported or withheld (report option). Participants reported more answers in the informal context. In the formal context, single answers were preferred, and they were more frequently reported. We conclude that social context influences the level of informativeness in a conversation, affecting achievable accuracy. Our results also show the joint influence of the confidence and the social context on willingness to share information.     

The influence of lawyers' questions on witness accuracy,confidence, and reaction times and on mock jurors' interpretation of witness accuracy

Two studies demonstrate the influence of lawyers' complex questions on mock‐witness accuracy, confidence, and reaction times and on the interpretation of witness accuracy by mock jurors. In study one, 32 mock witnesses were shown a short film and then questioned either with lawyers' complex questions or simple alternatives. In Study 2, 20 mock jurors viewed video footage of the mock witnesses assigned to each of the two previous conditions and were asked to rate their confidence in the witnesses' answers. The findings of the two studies indicated that lawyers' use of confusing questions reduce not only accuracy but also speed of response and both witnesses' and jurors' ability to determine accuracy. The implication of these findings is straightforward, lawyers should ask simple questions wherever possible. Copyright © 2010 John Wiley & Sons, Ltd.     

Prevention of marital instability and distress. Results of an 11-year longitudinal follow-up study

Divorce and destructive couple conflict are major risk factors for many forms of dysfunction and psychopathology in the family. Couple relationship education has been offered in an attempt to reduce those risks and enhance couple outcomes. The current effectiveness study had two aims: to assess (a) the long-term effects of relationship education and (b) the ability of partners to remember the skills typically taught during the communication skills training. One hundred and one couples from two studies, in which the effectiveness of the EPL (Ein Partnerschaftliches Lernprogramm für Paare [A Learning Program for Married Couples]) was investigated, were followed-up 11 years after the training. In the first study, EPL-takers had a significantly lower divorce and separation rate (27.5%) than non-EPL-takers (52.6%). This finding was replicated in a second study, showing a 20% dissolution rate in EPL-takers. For those couples still together, the rate of happy relationships was 80% at the eleven-year follow-up - thus, there is optimism for longer married couples who are willing to focus on improving their relationships. Only about 55% of the partners could remember at least one speaker skill whereas 70% remembered at least one listening skill taught during EPL. Consequences for prevention programs in the couple domain are discussed.     

Family therapists as front line mental health providers in war-affected regions: using reflecting teams, scaling questions, and family members in a hospital in Central Africa

This paper will illustrate the utilization of systemic family therapy services inside a hospital in a war-affected region of the Central African Republic. Through an international non-governmental organization (NGO), the author, a family therapist, provided counselling supervision and services to hospital staff and patients in an area of open conflict in the northern region of the country. In circumstances of chronic insecurity fuelled by both government and rebel forces, families displaced in this region are vulnerable to numerous health conditions and social problems. Family therapy techniques and ideas were used to work with individuals, couples and families presenting with health and social problems resulting from HIV-TB, infections, chronic malnutrition, acute poisoning and beliefs about sorcery. Case examples illustrate the systems consultation model used with the mental health team in order to expand and promote the sustainability of patient mental healthcare in this underserved region.     

Questions about questions: New views on an old prejudice

The belief that good analysts do not ask, and do not answer, questions is a still-living strange recommendation, transmitted throughout psychoanalytic generations. The authors have extensively reviewed electronic databases and technical texts. They found that interrogative acts are largely omitted from technical considerations, generating a prejudice that does not consider questions as proper psychoanalytic tools, and they discuss possible foundations for this belief. The authors believe that the few authors that have touched on this issue have done so in a non-systematic and frequently incomplete form. Linguistic philosophy presents questions as speech acts : actions that are able to alter the equilibrium of dialogical discourses. This view permits psychoanalysts to understand the potentiality of questions to introduce psychic change because they can, simultaneously, interfere in the self, in the other and in the intersubjective relationship. An internal state of curiosity is described as a component of the mind of the analyst. Based on the argument of the ubiquity of the state of curiosity of the analyst, the authors carried out a set of technical propositions, regarding, on the one hand, when questions are not to be introduced (for instance, in the presence of free associations) and, on the other hand, when they would be useful as expanding factors of the preconscious-conscious system. Considering psychoanalyses as experiences of curiosity, they emphasize that both the internal state of curiosity of the analyst, and the eventual verbal questions put to the patient are potentially positive factors for psychic change. The authors present several clinical vignettes.     

The effect of long‐term training on police officers' use of open and closed questions in field investigative interviews of children (FIIC)

This study intends to assess the effect of long‐term training on police officers' use of open and closed questions in investigative interviews of children. One hundred field investigative interviews of children were divided into two groups based on the interviewers' level of competence (training and experience). The police officers' questions were classified into groups of either open or closed. In all interviews, the mean numbers were 20 open and 217 closed questions, corresponding to an open–closed question ratio of 1:10. The most competent interviewers used 22 open questions and the less competent used 19 open questions, but the difference was not statistically significant. Analyses of variance (ANOVA) showed a significant effect of question but no main effect of competence. ANOVA revealed a descending number of open questions during the interviews, whilst the distribution of closed questions showed an inverted U distribution with most frequent use of closed questions in the middle part of the interviews. Possible strategies of enhancing the use of open questions are discussed. Copyright © 2006 John Wiley & Sons, Ltd.     

重估测谎决策的Bayes推断试验

谎与非谎的情绪反应没有独立的客观标准,以Polygrapy构成技术的测谎缺乏稳定的效度。本研究尝试运用Bayes方法分析一项实测案例,计算两名被试的低显性测谎反应结果,使准确判决有谎的概率由机会水平50％分别调整到可明确分辩的74％和49％,从决策分析角度为改良测谎程序和提高测谎效率提供了一种新的操作思路。     

从皮亚杰到柯尔伯格——兼论道德认知理论的哲学问题

从皮亚杰到柯尔伯格的道德认知理论是富有创新性的心理学理论 ,它以实证的方法研究了道德认知的发生和发展 ,对道德教育实践产生了巨大的影响。道德认知理论与现代唯物主义的精神实质相一致 ,并体现了丰富的辩证思维。但其理论在哲学世界观和方法论方面 ,存在一些自身不能解决的问题 ,对这些问题进行分析 ,有助于道德科学研究和伦理哲学研究的发展。