Web-based CBT for the prevention of anxiety symptoms among medical and health science graduate students

ABSTRACT

Medical and health science graduate students report greater anxiety problems than the general population, but they are less likely to seek treatment due to cultural and logistical barriers. One preventative approach that overcomes these barriers is web-based cognitive behavioral therapy (webCBT). It is unknown whether webCBT is effective for preventing anxiety escalation within this population. A randomized controlled trial was conducted, comparing the effects of webCBT versus a control group (CG). Medical university students (n=594; Mage=27; 67% female; 80% Caucasian) completed online baseline measures and four assigned online activities. Measures were re-administered after approximately three months. There was a small interaction effect between time of assessment and treatment condition. Anxiety severity was lower in the webCBT (M[SD]=2.88[3.36]) versus CG condition (M[SD]=3.69 [3.35]) at follow-up. This effect was moderate for students with mild, versus minimal, anxiety at baseline. The proportion of students with possible anxiety disorder was lower in the webCBT (4.5%) versus CG (8.5%) condition, and the proportion of mildly anxious students with a clinically significant increase in symptoms was lower in the webCBT (10%) versus CG (20%) condition. WebCBT may aid in preventing anxiety escalation in this population, particularly for at-risk students who report mild anxiety symptoms.     

自我效能感与网络健康信息搜寻关系的元分析

自我效能感与网络健康信息搜寻行为的关系如何,目前研究存在较大分歧。为明确二者关系,探究分歧原因,对检索后获得的44项研究(46个独立效应值)使用随机效应模型进行元分析。结果发现：自我效能感与网络健康信息搜寻行为存在中等显著正相关(r=0.27, 95%CI=[0.21, 0.33]);二者的相关强度受文化背景和被试健康状况的调节,但不受性别、自我效能感测量指标和网络健康信息搜寻行为测量指标的影响。结果初步澄清了健康信念模型、信息搜寻综合模型和风险感知态度框架的争论,表明个体自我效能感水平越高,其网络健康信息搜寻行为往往也会越频繁。研究启示政府和健康医疗从业者可以通过开展网络使用技能培训等干预方式提升公众自我效能感水平,间接促进公众的网络健康信息搜寻行为。     

百善孝为先?大学生双元孝道信念与网络成瘾的关系研究

本研究基于双元孝道模型和病理性互联网使用的认知行为模型,考察双元孝道信念对网络成瘾的影响,并检验非适应性认知的中介作用。以1152名大学生为被试,采用双元孝道信念量表、非适应性认知量表和网络成瘾量表进行测试,结果发现：（1）互惠性孝道和非适应性认知显著负相关,和网络成瘾显著负相关;权威性孝道和非适应性认知显著正相关,和网络成瘾显著正相关;非适应性认知和网络成瘾显著正相关;（2）非适应性认知在孝道信念与网络成瘾之间起中介作用。具体而言,互惠性孝道负向影响非适应性认知,权威性孝道正向影响非适应性认知,非适应性认知正向影响网络成瘾。本研究的结果表明,根植于中国传统文化的孝道信念通过非适应性认知的中介作用影响网络成瘾;而且互惠性孝道和权威性孝道具有相反的作用。     

“I'm a police officer not a social worker or mental health nurse”: Online discourses of exclusion and resistance regarding mental health‐related police work

Despite estimates suggesting that around 15% of UK police incidents involve people with a mental health concern, officers receive very little mental health training. The police have faced high‐profile criticisms over their handling of mental health‐related incidents, whereas the underfunding and fragmentation of UK mental health services has led to concerns that police officers are being forced to undertake a primary role in mental health care. At a time of austerity and widespread cuts to public services, it is important to explore how particular groups work to justify the parameters of their professional duties. This article therefore explores the discourses surrounding mental health problems on an online police discussion forum, highlighting two distinct ways in which mental health‐related work is represented as being incompatible with policing. First, mental health problems are delegitimised and conflated with “scrounging,” positioning individuals as undeserving of police time; second, mental health problems are reified and associated with violence and extreme behaviour, justifying the use of force by police officers and deflecting responsibility onto mental health services. Findings are consistent with previous research suggesting that mental health work is not perceived to be a valid part of the police role.     

儿童网络使用与学业成就：有调节的中介模型

摘 要 为探讨网络使用对学业成就的影响及其作用机制,从自我效能感理论的角度使用问卷对425名小学生进行调查。结果表明：（1）网络使用完全通过学习效能感的中介作用正向预测学业成就;（2）学习效能感中介作用受到开放性的调节,即在开放性高的个体中,学习效能感在网络使用与学业成就之间的中介效应不显著;在开放性低的个体中,学习效能在网络使用与学业成就之间有显著的中介效应。研究结果揭示了网络使用对学业成就的影响与作用机制,对家长、教育工作者根据儿童的个人特质对网络使用进行适度引导有启示意义。     

Virtual voices: social support and stigma in postnatal mental illness Internet forums

Many women with postnatal mental illness do not get the treatment they need and this is often because stigma prevents disclosure. The purpose of this study was to explore online social support for postnatal mental illness, how women experience stigma and potential disadvantages of using Internet forums. Interviews were conducted with fifteen participants who had suffered postnatal mental illness and had used forums. Systematic thematic analysis identified common themes in relation to social support, stigma and disadvantages of using forums. Most women felt they benefited from visiting forums by developing a shared understanding and discourse about their illness. Findings suggest future research should investigate if women benefit from using online social support provided by forums, if use challenges stigma and further explore potential concerns about using forums.     

Analytical practice: do the new technologies have an impact?

Through commentary on four clinical vignettes, this article focuses on the anthropological transformations taking place in contemporary society, underlining their differences from the anthropologies of reference of the founding fathers of psychoanalysis. Hybridization between man and machine and the speeding up and alteration of communications which the new technologies promote are now crucial issues facing psychoanalysis. Social media and a 24/7 internet connection have produced deep changes in the way people live and perceive relationships. Analytical practice is not exempt from such issues, which can be particularly insidious, often subtle and difficult to recognize, or even underestimated or ignored by psychoanalysts outright, in order to preserve the illusion of a complete understanding of what unfolds in the analytical space. The authors suggest that such transformations, by (partially) rendering inadequate the theoretical and technical corpus on which the various depth psychologies are founded, require personal engagement on the part of psychoanalysts in the search for new strategies to treat their patients, with the consequent abandonment of the ‘certainties’ offered by sclerotic models of clinical procedure.