Anxiety and depressive disorders are among the most commonly diagnosed psychiatric disorders, yet they remain largely undertreated in the U.S. and Black adults are especially unlikely to seek or receive mental health services. Symptom severity has been found to impact treatment-seeking behaviors as have sociocultural factors. Yet no known research has tested whether these factors work synergistically to effect willingness to seek treatment. Further, emerging data point to the importance of transdiagnostic risk factors such as intolerance of uncertainty (IU). IU may be negatively related to seeking treatment given that Black adults may be uncertain whether treatment might benefit them. Thus, the current study examined the relations between symptom severity/IU and willingness to seek treatment for anxiety/depression problems and the impact of key sociocultural variables (i.e., cultural mistrust–interpersonal relations [CMI-IR], perceived discrimination [PED]) on these relations among 161 (85% female) Black undergraduates. Consistent with prediction, symptom severity was positively related to willingness, but unexpectedly, IU was positively related. There was a significant Symptom Severity × CMI-IR interaction such that severity was positively related to willingness among students with lower cultural mistrust, but not higher mistrust. There were also significant IU × PED interaction such that IU was positively related to willingness among students with lower PED, but not higher PED. Results highlight the importance of considering the interplay between symptom severity, transdiagnostic vulnerability factors, and sociocultural variables when striving to identify factors related to treatment seeking behaviors among anxious and/or depressed Black students. 相似文献
Guided internet CBT (iCBT) is a promising treatment for depression; however, it is less well known through what mechanisms iCBT works. Two possible mediators of change are the acquisition of cognitive skills and increases in behavioral activation. We report results of an 8-week waitlist controlled trial of guided iCBT, and test whether early change in cognitive skills or behavioral activation mediated subsequent change in depression. The sample was 89 individuals randomized to guided iCBT (n = 59) or waitlist (n = 30). Participants were 75% female, 72% Caucasian, and 33 years old on average. The PHQ9 was the primary outcome measure. Mediators were the Competencies of Cognitive Therapy Scale–Self Report and the Behavioral Activation Scale for Depression–Short Form. Treatment was Beating the Blues plus manualized coaching. Outcomes were analyzed using linear mixed models, and mediation with a bootstrap resampling approach. The iCBT group was superior to waitlist, with large effect sizes at posttreatment (Hedges’ g = 1.45). Dropout of iCBT was 29% versus 10% for waitlist. In the mediation analyses, the acquisition of cognitive skills mediated subsequent depression change (indirect effect = -.61, 95% bootstrapped biased corrected CI: -1.47, -0.09), but increases in behavioral activation did not. iCBT is an effective treatment for depression, but dropout rates remain high. Change in iCBT appears to be mediated by improvements in the use of cognitive skills, such as critically evaluating and restructuring negative thoughts. 相似文献
Suicide is the second leading cause of death for those ages 13–25 in the United States. Coping is a mediator between stressful life events and adverse outcomes, and coping skills have been incorporated into interventions (e.g., cognitive-behavioral therapy, dialectical behavior therapy, safety-planning interventions) for suicidal populations. However, longitudinal research has not directly examined the prospective associations between multiple coping styles and suicide-related outcomes in high-risk samples. This study identified cross-sectional and 4-month longitudinal associations of coping styles with suicide risk factors (i.e., depression, suicidal ideation, suicidal behavior) in a sample of 286 adolescent and young adult psychiatric emergency patients. Positive reframing was the coping style most consistently associated with positive outcomes, whereas self-blame and disengagement were consistently associated with negative outcomes. Active coping protected against suicidal behavior for males, but not for females. This was the first study to examine longitudinal relationships between coping and suicide-related outcomes in a high-risk clinical sample. Findings suggest that clinical interventions with suicidal adolescents and young adults may benefit from a specific focus on increasing positive reframing and reducing self-blame. 相似文献
ABSTRACTThe aim of this study was to examine the extent to which cognitive emotion regulation strategies were “common or transdiagnostic correlates” of symptoms of depression and anxiety and/or “specific correlates” distinguishing one problem category from the other. The sample comprised 582 13- to 16-year-old secondary school students. Symptoms of depression and anxiety were measured by the SCL-90, and cognitive emotion regulation strategies were measured by the CERQ, in a cross-sectional design. Multivariate regression analyses were performed. Before controlling for comorbidity, the same cognitive emotion regulation strategies that were related to symptoms of depression were also related to symptoms of anxiety. However, after controlling for comorbid anxiety symptoms, rumination, self-blame (only girls), positive reappraisal, and positive refocusing (the latter two inversely) were uniquely (and significantly) associated with depression symptoms; and after controlling for comorbid depression symptoms, catastrophising and other-blame were uniquely related to anxiety symptoms. The results supported the cognitive content-specificity model, in which anxiety is supposed to be uniquely characterised by thoughts concerning the overestimation of threats and harm, and depression is supposed to be uniquely characterised by negative evaluations of self, and of past and future events. 相似文献
ABSTRACTHarassment of Asian American (AA) women has received little attention in popular culture and academic research despite their long legacy of sexualized racial stereotyping (e.g., Geisha, sexually submissive; Shimizu, 2007) and additional risk of mistreatment due to their membership in both marginalized gender and racial groups (Beale, 1970Beale, F. (1970). Double jeopardy: To be Black and female. In T. C. Bambara (Ed.), The Black woman: An anthology (pp. 90–100). New York: New American Library.[Google Scholar]; Settles & Buchanan, 2014Settles, I. H., & Buchanan, N. T. (2014). Intersectionality: Multiple categories of identity and difference. In V. Benet-Martinez and Y. Hong (Eds.), The Oxford Handbook of Multicultural Identity (pp. 160–180). New York, NY: Oxford University Press, Inc.[Google Scholar]). This study addresses this dearth of research using an intersectional theoretical framework to comprehensively examine sexual and racial harassment with a sample of AA women. Results validated the underlying factor structure of the Sexual Experiences Questionnaire (Fitzgerald, Gelfand, & Drasgow, 1995Fitzgerald, L. F., Gelfand, M. J., & Drasgow, F. (1995). Measuring sexual harassment: Theoretical and psychometric advances. Basic and Applied Social Psychology, 17, 425–445. doi:10.1207/s15324834basp1704_2[Taylor & Francis Online], [Web of Science ®], [Google Scholar]) and the Racial Acts, Crimes, and Experiences Scale (RACES; Bergman & Buchanan, 2008Bergman, M., & Buchanan, N. T. (2008). Development of the Racial Acts, Crimes, and Experiences Survey (RACES). Unpublished instrument.[Google Scholar]) for AA women. Additionally, our results replicated previous research indicating that participants often reported experiencing behaviors that constitute harassment, but did not label them as such. This supports the use of behavioral measures over items that require individuals to label their experiences as harassment. Finally, we examined the associations between these forms of harassment and two indicators of psychological well-being, depression, and posttraumatic stress (PTS). Our results found that gender harassment was associated with more depression, whereas unwanted sexual attention, sexual coercion, and racial harassment were associated with increased PTS. This supports the utility of including both sexual and racial harassment in providing a more nuanced understanding of AA women’s harassment experiences overall and the relationship of harassment to psychological well-being. We discuss theoretical and clinical implications of these findings. 相似文献
The aim of this analysis was to explore whether pre-treatment intervention preferences were related to outcomes for patients with persistent sub-threshold and mild depression who received one of two treatment types. Thirty-six patients took part in a two-arm, parallel group, pilot randomized controlled trial that compared short term (3 month and 6 month) outcomes of person-centred counselling (PCC) compared with low-intensity, CBT-based guided self-help (LICBT). Patient preferences for the two interventions were assessed at baseline assessment, and analysed as two independent linear variables (pro-PCC, pro-LICBT). Eight out of 30 interactions between baseline treatment preferences and treatment type were found to be significant at the p < .05 level. All were in the predicted direction, with patients who showed a stronger preference for a treatment achieving better outcomes in that treatment compared with the alternative. However, pro-LICBT was a stronger predictor of outcomes than pro-PCC. The findings provide preliminary support that treatment preferences should be taken into account when providing interventions for patients with persistent sub-threshold and mild depression. It is recommended that further research analyses preferences for different treatment types as independent variables, and examines preferences for format of treatment (e.g. guided self-help vs. face-to-face). 相似文献
Objectives: Weight cycling is linked with advanced breast cancer diagnosis, increased risk of cancer reoccurrence and cancer-related mortality. While women treated for breast cancer report challenges with navigating their post-treatment body shape and weight, the effects of weight cycling on body image and mental health have not been elucidated. This study examined associations between weight changes and weight cycling on psychological health (i.e. weight-related guilt, shame and depressive symptoms) among women in the first-year post-treatment.
Design and Outcome Measures: Self-reported assessments of pre-cancer weight cycling, post-treatment weight-related guilt, shame and depressive symptoms, and objective assessments of weight were assessed in a longitudinal sample of 173 women treated for breast cancer (Mage = 55.01 ± 10.96 years).
Results: Based on findings from multilevel models, women experienced the most weight-related shame when their weight was heavier than their personal average. Additionally, heavier weight was associated with worse psychological health, particularly for women with a history of stable (vs. cycling) weight pre-cancer.
Conclusions: Weight cycling pre-cancer and post-treatment weight change have important implications for psychological well-being. Due to the potential psychological consequences associated with a history of weight cycling, targeted strategies are needed to improve overall health outcomes for women’s survivorship after breast cancer. 相似文献