Cognitive-behavioral treatment and antidepressants combined with virtual reality exposure for patients with chronic agoraphobia

In this study we compared the efficacy of virtual reality exposure combined with cognitive-behavioral therapy (VRET) to that of traditional cognitive-behavioral therapy (CBT) alone in reducing phobic symptoms in a sample of patients with long-term agoraphobia. The study was a between-subject design with three experimental conditions (VRET group, N = 30; CBT group, N = 30; and medication only group, N = 20) and repeated measures (pre-treatment, post-treatment, and six-month follow-up). All patients were receiving antidepressant medication. Results showed that all therapies were statistically effective both at post-treatment and six-month follow-up. The VRET group showed clinical improvement in most variables measured at follow-up. The CBT group showed the highest dropout rates. These results are discussed pointing out that VRET probably serves as an intermediate procedure for an efficient exposure to phobic stimuli. Besides describing the advantages of VRET for the treatment of agoraphobia symptoms in cost-benefit terms, the study also considered issues related to higher treatment adherence and motivation.     

The Dimensionality of Right-Wing Authoritarianism: Lessons from the Dilemma between Theory and Measurement

The RWA Scale ( Altemeyer, 1981 , 1988 , 1996 ) is commonly regarded as the best measure of right-wing authoritarianism. The one-dimensional instrument assesses the covariation of three attitudinal clusters: authoritarian submission, authoritarian aggression, and conventionalism. The incongruence between the implicit conceptual dimensionality on the one hand and methodological operationalization on the other makes room for discussion about whether it would be advantageous to measure the 3 facets of RWA separately. I rely on three arguments: (1) confirmatory factor analyses showing that three-dimensional scales fit the data better than the conventional one-dimensional practice; (2) the dimensions showing a considerable interdimension discrepancy in their capability to explain validation criteria; and (3) the dimensions showing an intradimensional discrepancy which is dependent upon the research question. The argumentation is illustrated by empirical evidence from several Web-based studies among German Internet users.     

社会支持、主动反刍与创伤后应激障碍的关系:来自地震后青少年的追踪研究

以追踪研究的方式,在汶川地震后3.5年、4.5年和5.5年三个时间点,采用社会支持问卷、反刍问卷和创伤后应激障碍量表对汶川地震后245名中学生进行调查。通过建立交叉滞后模型,考察社会支持、主动反刍与创伤后应激障碍(PTSD)的相互作用关系。结果发现,震后3.5年至5.5年间,社会支持与主动反刍之间的跨时间点预测作用不显著,PTSD对社会支持的跨时间点预测作用不显著,但对主动反刍具有显著的跨时间点正向预测作用。震后3.5年至4.5年间,社会支持对PTSD的跨时间点负向预测作用、主动反刍对PTSD的跨时间点正向预测作用均显著,但是这些作用在震后4.5年至5.5年间变得不再显著。     

Individual Resiliency Factors from a Genetic Perspective: Results from a Twin Study

This article is part of the Twin Mother's Study, a study that examines influences on maternal adjustment. A number of studies have investigated the importance of genetic factors for mental health, but few of these examine how genes and the environment influence resiliency/salutogenic factors. This article investigates the relative importance of genetic and environmental influences on resiliency/salutogenic factors. This study includes 326 twin pairs (150 monozygotic and 176 dizygotic) who are mothers, who are living with their spouse, and who are part of the Swedish twin register. Using self‐report structured questionnaires, we assessed salutogenic factors, depression, and quality of life; however, we analyzed the questionnaires completed by the mothers. Statistical analyses were conducted using structural equation modeling. We conclude that nonshared environmental components were of principal importance in individual resiliency/salutogenic factors in a genetically informative design, but we also noted that genetic influences were important. The shared environment had mainly no effect.     

Active school travel is associated with fewer suicide attempts among adolescents from low-and middle-income countries

Background/Objective: This study explored the association between active school travel (AST) and suicide attempts among adolescents in low- and middle-income countries (LMICs). Method: We used the data from the Global School-based Health Survey, including 127,097 adolescents aged 13-17 years from 34 LMICs. A self-reported survey was used to collect data on AST and suicide attempts as well as some variables. Multivariable logistic regression was performed to assess the association between AST and suicide attempts. A meta-analysis with random effects was undertaken to identify the difference in the association between AST and suicide attempts. Results: Across all the adolescents, the prevalence of AST was 37% and the prevalence of suicide attempts was 11.60%. Adolescents who engaged in AST were less likely to have suicide attempts irrespective of gender. The country-wise analysis indicated a large inconsistency in the association between AST and suicide attempt across the countries. Conclusions: AST would appear to be a protective factor for reducing suicide attempts among adolescents. However, the association between AST and suicide attempts varied greatly across the countries. Future studies should confirm the association between AST and suicide attempts.     

Depression screening and treatment among uninsured populations in Primary Care

Uninsured populations have poor treatment engagement and are less likely to receive evidence-based interventions for depression. The objective of the current study was to retrospectively examine depression screening, diagnosis, and treatment patterns among uninsured patients in primary care. Study sample included all patients (N = 11,803) seen in nine community-based clinics. Key variables included depression screener and/or a depression diagnosis, anti-depressant initiation, behavioral health visits, and patient follow up measures. Treatment patterns from the subsample of patients diagnosed with depression were analyzed by collecting the number of behavioral health visits and antidepressant use six months (180 days) following the diagnosis. Utilization of the depression screening tool was high (67%, n = 7,935) and 24% (n = 2,789) of the patients had a diagnosis of depression, however, more than half of the patients with a depression diagnosis did not have a recorded treatment plan (n = 1,474). The odds of anti-depressant use and behavioral visits for Hispanic patients were significantly greater than for Non-Hispanic patients. Universal screening with brief measures in primary care is improving, however, guideline-concordant depression treatment remains elusive for uninsured populations.     

Effect of Concurrent Visual Feedback Frequency on Postural Control Learning in Adolescents

The purpose was to find better augmented visual feedback frequency (100% or 67%) for learning a balance task in adolescents. Thirty subjects were divided randomly into a control group, and 100% and 67% feedback groups. The three groups performed pretest (3 trials), practice (12 trials), posttest (3 trials) and retention (3 trials, 24 hours later). The reduced feedback group showed lower RMS in the posttest than in the pretest (p = 0.04). The control and reduced feedback groups showed significant lower median frequency in the posttest than in the pretest (p < 0.05). Both feedback groups showed lower values in retention than in the pretest (p < 0.05). Even when the effect of feedback frequency could not be detected in motor learning, 67% of the feedback was recommended for motor adaptation.     

Relationship of religiosity to mental health literacy,stigma, social distance,and occupational restrictiveness in Ningxia Province,China

Little research has assessed the relationship between religiosity and mental health awareness in low- and middle-income countries. This study identified a representative sample of 2,425 community-dwelling adults in Ningxia, China and administered the Duke University Religion Index, the Mental Health Knowledge Questionnaire, the Mental Health Attitude Questionnaire, the Social Distance – Personal Questionnaire and the Social Restrictiveness – Occupational Questionnaire. Religious affiliation per se was not associated with mental health literacy or attitudes, but higher levels of religiosity were associated with better awareness of mental health issues and less social distance and occupational restrictiveness of those with mental health conditions. However, these relationships were substantially different in Hui ethnicity respondents (85% of whom were practicing Islam) and Han ethnicity respondents (15% of whom practiced Buddhism, Taoism or Confucianism).     

Anger and aggression in women: Influence of sports choice and testosterone administration

We report on two studies of anger and aggression in women. One study concerns an experimental study of anger induction in aggressive and non-aggressive sportswomen. It was found that sports choice in itself, contrary to expectation, does not predict anger arousal and aggressive behavior in the laboratory. However, at an individual level the anger proneness of the subject, as measured by a questionnaire we developed, was related to the intensity of aggressive behavior and subjectively reported anger. The second study concerns the activating effects of androgens on aggression and anger proneness. In a group of 22 female-to-male transsexuals, a battery of anger proneness and aggression questionnaires was administered twice: shortly before and 3 months after the start of androgen treatment. Administration of androgens was clearly associated with an increaese in anger proneness, although there were no changes in several aspects of overt aggressive behavior. © 1994 Wiley-Liss, Inc.