Who drops-out? Do measures of risk to self and to others predict unplanned endings in primary care counselling?

Aims: Unplanned endings, where clients unilaterally end therapy, are of concern for psychological therapy services generally as they raise questions about the appropriateness of the treatment and it's delivery for some clients. Limited available data indicates that those who drop-out often have more severe symptoms at entry, and have poorer clinical outcomes. This raises further questions about risk to self and others for those clients who leave therapy prematurely and how these clients might be identified and kept engaged. Method: This paper uses a large dataset of CORE data collected routinely in a primary care counselling service between 2000 and 2003. Logistic regression was utilised to consider different measures of risk and other client characteristics recorded at assessment to predict drop-out from the service. Results: These indicate that younger age, greater psychological distress at assessment, an addiction problem and greater risk to others, are associated with an unplanned ending. However, no reliable logistic regression model could be produced. This may be partly due to data quality issues or important characteristics not being available in the data. Implications for practice: The paper concludes that counsellors should actively seek to minimise unplanned endings, as amongst them may be represented the more distressed and risky clients referred to primary care counselling.     

Excessive Object Attachment in Hoarding Disorder: Examining the Role of Interpersonal Functioning

Excessive attachment towards possessions can be maladaptive because it can lead individuals to excessively acquire and save objects. Little is known about how attachment to objects develops and changes over time; however, interpersonal factors have been theorized to play a role. The current study examined whether interpersonal factors, specifically interpersonal attachment style and empathy, moderate changes in object attachment over time. A total of 145 participants with excessive acquiring and discarding difficulties rated their level of attachment to a novel object just after receiving it, and 1 week later. Participants also completed measures of interpersonal anxious attachment and interpersonal functioning. We found that changes in object attachment over time were moderated by interpersonal anxious attachment. Also, our findings suggested that individuals with hoarding problems are likely not impaired in their ability to empathize with others, but rather have difficulty displaying empathy in tense social situations and also have more empathy for fictional characters. Further, greater discomfort in tense social situations and greater empathy for fictional characters interacted to predict greater object attachment. Taken together, these findings indicate that individuals with an interpersonal anxious attachment style may be those at risk of forming greater attachments to objects over time. A learning history that includes inconsistent support from caregivers may result in individuals experiencing more empathy for fictional characters and discomfort in tense social situations, which may produce a vulnerability for becoming excessively attached to objects. Our results are in line with theories of hoarding which propose that individuals use objects to compensate for unmet interpersonal needs and suggest that treatment may need to target interpersonal functioning to reduce hoarding symptoms.     

Social influence matters: We follow pandemic guidelines most when our close circle does

Why do we adopt new rules, such as social distancing? Although human sciences research stresses the key role of social influence in behaviour change, most COVID-19 campaigns emphasize the disease’s medical threat. In a global data set (n = 6,675), we investigated how social influences predict people’s adherence to distancing rules during the pandemic. Bayesian regression analyses controlling for stringency of local measures showed that people distanced most when they thought their close social circle did. Such social influence mattered more than people thinking distancing was the right thing to do. People’s adherence also aligned with their fellow citizens, but only if they felt deeply bonded with their country. Self-vulnerability to the disease predicted distancing more for people with larger social circles. Collective efficacy and collectivism also significantly predicted distancing. To achieve behavioural change during crises, policymakers must emphasize shared values and harness the social influence of close friends and family.     

Interactive effects of social network centrality and social identification on stress

The present study aimed to integrate the social identity approach to health and well-being with social network analysis. Previous research on the effects of social network centrality on stress has yielded mixed results. Building on the social identity approach, we argued that these mixed results can be explained, in part, by taking into account the degree to which individuals identify with the social network. We hence hypothesized that the effects of social network centrality on stress are moderated by social identification. Using a full roster method, we assessed the social network of first-year psychology students right after the start of their study programme and three months later. The effects of network centrality (betweenness, closeness, eigenvector centrality) and social identification on stress were examined using structural equation models. As predicted, our results revealed a significant interaction between network centrality and social identification on stress: For weakly or moderately identified students, network centrality was positively related to stress. By contrast, for strongly identified students, network centrality was unrelated to stress. In conclusion, our results point to the perils of being well-connected yet not feeling like one belongs to a group.     

General vs health‐specific consideration of immediate and future consequences to explain eating and exercise behavior in a Norwegian student population: A randomized survey experiment

Over several decades, the consideration of future consequences (CFC) construct has been used to explain and predict health behaviors. However, the reported associations between CFC and health behaviors are relatively weak, leading to the low explanatory power of the models. Recent research suggests that CFC can be a domain‐specific construct. In this study, we explored the psychometric properties of the Norwegian CFC‐general and CFC‐health questionnaires in terms of factor structure and discriminant and convergent validity and tested the association between the general and domain‐specific CFC and exercise and eating behaviors. In a randomized survey experiment, 1,001 university students were assigned to either a CFC‐general or a CFC‐health questionnaire. In the tested models, two dimensions of CFC, consideration of immediate consequences (CFC‐I) and consideration of future consequences (CFC‐F), were independent variables. The exercise and eating behaviors, measured both as self‐evaluated behaviors and self‐reported frequency measures, were dependent variables. The results showed that in both CFC‐general and CFC‐health, CFC‐I and CFC‐F are distinct dimensions that differentially explain variance in health behaviors. A domain‐specific CFC‐health explained a significantly higher amount of variance in self‐reported eating and exercising behaviors than a general CFC. Self‐evaluated health behaviors were better explained by CFC than self‐reported behavioral frequencies. Practical implications of the findings and avenues for future research are discussed.     

基本需要在导师排斥感知与研究生心理健康的关系中的作用

为探讨导师排斥感知对研究生心理健康的影响及作用机制,本研究采用导师排斥感知问卷、基本需要问卷、生活满意度量表、简版流调中心抑郁量表及攻击问卷,对北京市六所本科院校的864名在校硕士和博士研究生进行问卷调查。结果发现：（1）导师排斥感知正向预测研究生的抑郁和攻击性,负向预测其生活满意度;（2）基本需要在导师排斥感知与研究生的生活满意度、抑郁之间起着完全中介作用,在导师排斥感知与攻击性之间起部分中介作用。结果表明,研究生导师排斥感知越强,基本需要的满足水平越低,进而导致研究生的抑郁水平越高、攻击性越强、生活满意度越低。即研究生感知的导师排斥感越强,其心理健康水平越低。     

Performance of Mental Health Counselors in Integrated Primary and Behavioral Health Care

Integrated primary and behavioral health care (IPBH) is becoming a preferred mode of service delivery in the United States. Integrated care includes the participation of medical and mental health professionals, such as mental health counselors. The clinical outcomes of these professionals need to be studied to determine their effectiveness in such settings. We examined the performance of 10 mental health counselors on the clinical outcome of 1,747 clients treated in an IPBH center. Analyses using growth curve modeling and pre‐post test design revealed that mental health counselors were effective overall, but they differed in client dropout rates and efficiency in reducing clients' initial symptoms. We used the analyses to rank order counselors based on their effectiveness. Counselors who were the most effective varied in their efficiency but demonstrated the lowest client dropout rates. Implications for future research and counseling practice were discussed.     

Collaborative competence,social capital,and mental health: A cross‐sectional analysis of a community‐based intervention for older adults

Social capital interventions for the mental health of older adults have been inconclusive to date, and have rarely investigated the psychological resources that are important to having social capital. This study focused on the “Neighborhoods in Solidarity” (NS), which are a series of Swiss community‐based interventions that aim to empower older adults to participate in their communities. Our goal was to understand whether the NS were associated with collaborative competence, social capital, and subsequently, symptoms of depression. Cross‐sectional data were collected from 947 individuals aged 55 and over (M_age = 68.66, SD = 9.04) in 10 Swiss neighbourhoods (five with the NS [n = 479] and five control neighbourhoods [n = 468]). Structural equation modelling was used to model the relationship between the NS intervention, collaborative competence, cognitive and structural dimensions of social capital, and symptoms of depression (measured by the CESD‐R‐10). Individual participation in the NS had total and indirect effects on symptoms of depression via collaborative competence and both social capitals. These findings suggest that existing community‐based interventions can be indirectly associated with better mental health outcomes in the ageing population.     

Sexual activity while driving: A content analysis of media reports

Sexual activity while driving fits the definition of distracted driving because it involves the diversion of attention away from the driving task. However, this risky driving behaviour has received little attention compared to other distracted driving activities. To address the lack of research on sexual activity while driving, the internet was searched from April to June 2020 for media reports in which sexual activities occurred within the cabin of a moving vehicle, taking specific note of: gender, the presence of others, time of day, use of substances, the nature of the circumstances surrounding the incident, and whether crashes had occurred. A total of 106 unique and verified cases were identified from 2004 to 2020. The reports involved 76 male (71.7%) and 30 female drivers (28.3%), and there were 43 (40.5%) serious incidents that involved a crash and 23 fatalities (21.7%). In 17 (16.0%) incidents their vehicle hit another car, and a pedestrian or cyclist was hit in 3 (2.8%) incidents. The risk of a serious incident was higher during oral sex or intercourse than solitary activities (i.e. masturbation). A total of 63 (59.5%) mild incidents (without crashes or fatalities) were identified, in which reports included accounts by witnesses or police regarding sexual activity while driving. Given the potential seriousness of incidents, this topic deserves further research to better understand the prevalence and safety implications of sexual activity while driving.