Changes in affect during treatment for depression and anxiety

We tested the hypothesis that the tripartite model [Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and psychometric implications. Journal of Abnormal Psychology, 100, 316-336] can be extended to account for change during treatment for anxiety and depression. Forty-one patients treated naturalistically in private practice with cognitive behavior therapy completed weekly measures of depression, anxiety, negative affect (NA), positive affect (PA), and anxious arousal (AA). Consistent with the model, NA was associated with anxiety and depression during treatment, PA was more strongly related to depression than to anxiety, and AA was more strongly related to anxiety than to depression. As predicted, symptoms of depression and anxiety and NA all decreased during treatment. As predicted, AA also decreased, particularly for patients with panic disorder. PA increased during treatment, but only for patients who showed a significant decline in depression and only over an extended period of treatment. Nearly two-thirds of the variance in anxiety change was accounted for by changes in depression and NA, and just over three-fourths of the variance in depression change was accounted for by changes in anxiety and NA, indicating that much of the change in anxiety and depression across the course of treatment is shared in common.     

The Need for Recovery scale: Adaptation to the Italian context

IntroductionNeed for Recovery scale is one of the main scales used to assess work-induced fatigue and quality of workers’ recovery time. In fact, need for recovery is considered relevant as a precursor of prolonged fatigue or psychological distress, an indicator of work stress, and a mediating or moderating characteristic in the etiology of work-related health problems, sick leave and work disability.ObjectiveThe purpose of the present study is to translate the Need for Recovery scale into Italian, and to adapt it to Italian culture; until now there has been no comparable valid instrument made for the Italian language that measures the need for recovery of employees. The stability and internal consistency of the scale will be assessed among Italian workers.MethodFor cross-cultural adaptation, a translation/back-translation method integrated with expert committee review and pre-testing was applied. Three hundred and seventy-eight Italian workers filled out the scale.ResultsThe psychometric properties proved to be good, both in terms of scale homogeneity and internal consistency, for the total sample and for subgroups of Italian employees in terms of gender, age and educational level. Exploratory factor analysis suggested a single factor solution with 44% of the variance explained.ConclusionsResults are encouraging for the possibility of using the Need for Recovery scale as a quick and adequate scale to measure early symptoms of work-induced fatigue and quality of Italian workers’ recovery time.     

Character strengths and clinical presentation

Abstract

Three models are described that attempt to integrate clinical diagnosis with the strengths-based model introduced by Peterson and Seligman (2004 Peterson, C., & Seligman, M. E. P. (2004). Character strengths and virtues: A handbook and classification. New York, NY: Oxford University Press. [Google Scholar]). The strengths as syndrome model proposes conceptualizing clinical diagnoses in terms of excesses and deficiencies in strengths. The strengths as symptoms model suggests conceptualizing clinical symptoms as excesses or deficiencies in strengths. After reviewing these two models, we introduce a third. The strengths as moderators model suggests that signature or deficient strengths can serve moderators of clinical presentation within traditional diagnostic categories. This differs from the prior models primarily in offering a complement rather than alternative to traditional diagnostic formulation. A clinical case is provided highlighting the differences. The three approaches are not incompatible with each other, and in combination may provide practitioners a variety of perspectives for employing strength-based concepts in clinical interactions.     

What Celebrity Case Studies Can Teach about Clinical Formulation of Mental Health Conditions

Abstract

A key challenge in the ‘making of the psychologist’ is how to teach clinical case formulation, which goes beyond just listing the symptoms that make the ‘diagnosis’. One approach which has been both effective and popular among students entails employing case studies of individuals who are celebrities with known mental health conditions and then exploring not only their presenting problems and symptoms, but also a detailed analysis of biopsychosocial predisposing concerns, precipitating events, perpetuating circumstances, and protective factors. Nine cases deemed to be particularly suitable for such psychobiographical instruction are reviewed to illustrate the learning points about case formulation. The cases were chosen because they provide a breadth of presenting symptoms and the individuals under consideration are ones who for the most part have been self-disclosing about their conditions, which makes the clinical material accessible for study; a number have been leaders in the fight against mental illness stigma. The use of celebrity case accounts serves to develop talents in case formulation and appreciation for the complexity of people and the developmental influences in identity formation. Further pedagogic benefits are heightened awareness of mental health stigma issues and the personal and societal barriers individuals face in seeking needed help.