Emotions Know Best: The Advantage of Emotional versus Cognitive Responses to Failure

Making mistakes or failing at tasks is a common occurrence in human life. People can respond to and cope with failure in many ways. In this research, we examine potential advantages of relatively emotional (versus cognitive) responses to failure. In particular, we study how effort and time spent in subsequent tasks depend on whether people predominantly focus on their emotions or their cognitions as they respond to a failure. We demonstrate that, left to their own means, people's cognitions upon a failure are mainly justificatory in nature and thus do not automatically have the commonly believed reflective, self‐improving qualities. We further argue and demonstrate that a relative focus on cognitions following a failure can prevent improvement in subsequent episodes, but a focus on emotions can allow for learning and, therefore, increased effort. Copyright © 2017 John Wiley & Sons, Ltd.     

Relation between coping and posttrauma cognitions on PTSD in a combat-trauma population

Individual differences in cognitive processes and coping behaviors play a role in the development and maintenance of posttraumatic stress disorder (PTSD). Given the large numbers of combat-exposed service members returning from the Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND) conflicts, exploring individual differences in cognitive-affective processes is important for informing our understanding of PTSD etiology and early intervention in military samples. The present study examined the unique main and interactive effects of negative posttrauma cognitions (i.e., negative beliefs about self [NS], the world [NW], and self-blame [SB]) and coping strategies (i.e., positive behavioral, positive cognitive, avoidant coping, and social and emotional coping) on PTSD diagnosis within 155 (M_age = 30.7, SD = 4.48) OEF/OIF/OND combat trauma-exposed Veterans recruited from an ongoing study examining the effects of combat trauma and stress reactivity. In the final, stepwise logistic regression analysis, avoidant coping, but no other coping strategy, was significantly positively related to PTSD diagnosis in the initial step. Higher levels of NS, but not NW, were significantly associated with having a PTSD diagnosis, whereas SB was associated with decreased likelihood of PTSD, above and beyond coping strategies. A significant interaction effect was found between NS and positive cognitive coping, such that greater positive cognitive coping weakened the relationship between NS and PTSD. Examining and addressing coping behaviors and negative thoughts of self jointly may benefit assessment and intervention approaches in a combat-trauma population.     

A preliminary examination of the role of psychotherapist fidelity on outcomes of cognitive processing therapy during an RCT for military sexual trauma-related PTSD

While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists’ fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD. PTSD symptoms, trauma-related negative cognitions (NCs), and depression symptoms were assessed for 72 participants at baseline, and 1-week, 2-month, 4-month, and 6-month posttreatment. Of the four CPT therapists, two were found to have significantly poorer (i.e. “below average”) treatment fidelity scores compared to the other two therapists who had “good” treatment fidelity scores. To examine possible therapist effects on outcomes, hierarchical linear modeling was utilized with therapist fidelity entered as a Level 2 predictor. Participants treated by a therapist with “good” treatment fidelity experienced significantly greater reductions in PTSD symptoms, NCs, and depression symptoms than patients treated by a therapist with “below average” treatment fidelity. Our preliminary findings highlight the importance of monitoring, maintaining, and reporting fidelity in psychotherapy treatment RCTs.     

Which Symptoms of Depression and Anxiety Matter Most? An Investigation of Subjective Importance Ratings With College Students in India

One goal of clinical psychological science is to help people with problems that matter to them. However, little is known about which kinds of symptoms are viewed as most important, particularly among individuals in non-western settings. We examined the extent to which young adults in India rated individual symptoms of depression and anxiety as important, concerning, and undesirable. Participants were college students at Indian Universities (n = 283). They received a measure of depressive symptoms (Patient Health Questionnaire-9) and anxiety symptoms (Generalized Anxiety Disorder Screener-7). For each of the 16 symptoms, they provided three judgments relating to the extent to which they found the symptom important, harmful, and undesirable. These judgments were averaged to form a “subjective importance rating” (SIR) for each symptom. Anxiety symptoms were viewed as more important than depressive symptoms (d = 0.34), and nonsomatic symptoms were viewed as more important than somatic symptoms (d = 0.83). Females rated symptoms as more important than males (d = 0.32), and individuals with higher self-reported symptoms rated symptoms as more important. Sad mood, suicidal ideation, and controlling worries were rated as the most important symptoms, whereas concentration problems, appetite problems, and psychomotor problems were rated as the least important. Overall, some symptoms are viewed as more important and concerning than others. We discuss how this understanding can affect our conceptualization, assessment, and treatment of mental disorders around the world.     

Elucidating the psychosocial context of ‘post‐concussion syndrome’ (PCS): a case study from post‐Milan systemic family therapy

The literature on post‐concussion syndrome (PCS) following mild head injury includes biopsychosocial formulations. However, it is contended that the complexities of the psychosocial remain conceptually underdeveloped. An engagement with this complexity is presented via a case study from post‐Milan systemic family therapy. The work described is with grandparents, a mother and daughter. The latter two both initially experienced PCS following a road traffic accident, yet demonstrated contrasting outcomes in the year post‐injury. Implications for family therapy services and the wider literature are discussed.     

Demarcating depression

How to draw the line between depression‐as‐disorder and non‐pathological depressive symptoms continues to be a contested issue in psychiatry. Relatively few philosophers have waded into this debate, but the tools of philosophical analysis are quite relevant to it. In this paper, I defend a particular answer to this question, the Contextual approach. On this view, depression is a disorder if and only if it is a disproportionate response to a justifying cause or else is unconnected to any justifying cause. I present four objections to this approach and then defend it from them. Along the way, I explain why it matters whether we get this question right.     

Pilot Effectiveness of a Stress Management Program for Sheltered Homeless Adults With Mental Illness: A Two-Group Controlled Study

This study examined the effectiveness of a stress management intervention for sheltered homeless adults with mental illness. Twelve intervention participants received a 6-week, 1-hour psychoeducation group combined with a 20-minute meditation. Eleven matched pairs did not receive intervention and served as controls. At 1 week post study, intervention participants reported a statistically significant reduction in perceived stress (Z=??2.285, p < .02, d=??1.176) compared to controls. No differences were found at 1 week post study between intervention and control participants on reported quality of life. This study provides pilot data on the effectiveness of an occupation-based stress management program for sheltered homeless adults and warrants further study.     

儿童病因认知发展的研究

对儿童病因认知发展的研究具有重要的理论和实践意义。近20年来,西方发展心理学家在该领域的研究逐渐从皮亚杰理论框架下的研究转变为“朴素理论”框架下的研究。在理论上,研究越来越强调领域特殊性;在研究思路上,研究逐渐从“自上而下”的研究转变为“自下而上”的研究;在研究方法上,研究不断降低任务难度,提高了任务的区分度和敏感性。该领域进一步的研究将更为深入和细致的探查儿童的病因认知。     

Prime and prejudice: Brief stereotypical media representations can increase prejudicial attitudes and behaviour towards people with schizophrenia

Prejudice against people with mental illnesses remains a significant problem in the United Kingdom and in many other countries despite sustained efforts by governments and charities. This is particularly so for people with schizophrenia, who are seen as dangerous and unpredictable. The present study investigated the effect of brief, casual, stereotypical representations on prejudice and behavioural intentions towards people with schizophrenia. Participants viewed Halloween costumes in an online environment under the guise of product research. In the experimental condition, they were exposed to a “Psycho Ward” Halloween outfit identical to one sold online by a leading supermarket chain in the United Kingdom. Participants in the control condition saw a neutral “pumpkin” Halloween costume. Exposure to the Psycho Ward outfit resulted in more negative behavioural intentions towards people with schizophrenia, mediated by increased prejudice. These findings confirm and extend earlier research that implicates adverse media stereotypes in the persistence of prejudice against people with mental illness. More research is warranted on the relative effects of different influences on community attitudes to mental illness.     

Ethical Considerations for Providing In-Home Mental Health Services for Homebound Individuals

The number of homebound individuals in the United States is on the rise, causing health-care professionals to expand in-home health services to help meet the increased demand. Due to the prevalence of feelings of isolation and depression in this population, it is imperative that mental health professionals join this effort to increase access to mental health services. Delivering psychotherapy in clients’ homes presents many advantages to these homebound individuals, but there is a dearth of literature addressing how therapists should handle unique ethical issues that arise in this type of setting. This article addresses ethical considerations and guidelines for in-home provision of mental health services. General ethical issues related to home-based psychotherapy include boundaries, confidentiality and privacy, competency, insurance coverage, and autonomy. Issues pertaining to different categories of homebound individuals, including persons with agoraphobia, chronic illnesses, and older adults, are then discussed in turn. Recommendations on how to best manage these issues by applying the American Psychological Association’s, the American Counseling Association’s, and the National Association of Social Workers’ Ethics Codes are provided.