Treating Young Adult Depression With Text-Delivered Cognitive Behavioral Therapy: A Pilot Randomized Clinical Trial

Young adults (ages 18 to 25) in the U.S. suffer from the highest rates of past-year major depressive episode and are the least likely to receive treatment compared to other age groups. As such, we examined the feasibility, acceptability, and efficacy of a text-message delivered cognitive behavioral therapy: CBT-txt with young adults. The study was a 2-month pilot RCT to test a 4-week intervention for depression that contained 197 text messages (average 12 texts every other day). The sample, recruited via Facebook and Instagram, was 102 U.S. young adults who presented with at least moderate depressive symptomatology. Assessments occurred at baseline prior to randomization and at 1 and 2 months post enrollment. The primary outcome, severity of depressive symptoms, was assessed using the Beck Depression Inventory II. Feasibility benchmarks were met and participants reported high levels of engagement with and acceptability of the intervention. Logistic regression indicated that treatment participants were three times as likely to have minimal or mild depression symptoms at 2 months compared to waitlist control participants. Latent change score modeling found that the strongest significant treatment effect appeared at the 1-month follow-up period, particularly for participants who began with severe depressive symptoms. Mediation analysis revealed significant indirect treatment effects of increases in behavioral activation on reducing depressive symptoms, suggesting a mechanism of change. Limitations were that the sample was relatively small and consisted of primarily women. These results provide initial evidence for the feasibility, acceptability, and efficacy of a text-delivered treatment for young adult depression.     

A transnational family story: A narrative inquiry on the emotional and intergenerational notions of ‘home’

At the core of migratory experiences lie key questions pertaining to one's emotional changing Self: the complexity of conflicting identities, feelings of (un)belonging, varying degrees of emotional place (un)attachment, and the fundamental (re)conceptualizations of ‘home’. Though well-studied from various angles, ‘home’ as an emotional concept in the context of generational family migration research has many gains yet to be made. Through an in-depth study on three generations of one author's own family, this paper provides personal insight into the intergenerational and emotional dimensions of this topic. Unanimously, the findings demonstrate that notions of ‘home’ as where family is remain predominant, with ties to transnationally dispersed family members rendering ‘home’ as multiple. Places of familial heritage further remain central in conceptualizations of ‘home’ through a retainment of cultural practices and values derived from familial homelands. Despite these cross-generational similarities, challenges and emotional uncertainties on the topic are seen to be increasingly prevalent in the youngest generation. Above all, interviewees' post-migration reflections demonstrate that such conceptualizations are intricate, relational and do not exist in an emotional vacuum.     

Reflexivity in quantitative research: A rationale and beginner's guide

Reflexivity is the act of examining one's own assumption, belief, and judgement systems, and thinking carefully and critically about how these influence the research process. The practice of reflexivity confronts and questions who we are as researchers and how this guides our work. It is central in debates on objectivity, subjectivity, and the very foundations of social science research and generated knowledge. Incorporating reflexivity in the research process is traditionally recognized as one of the most notable differences between qualitative and quantitative methodologies. Qualitative research centres and celebrates the participants' personal and unique lived experience. Therefore, qualitative researchers are readily encouraged to consider how their own unique positionalities inform the research process and this forms an important part of training within this paradigm. Quantitative methodologies in social and personality psychology, and more generally, on the other hand, have remained seemingly detached from this level of reflexivity and general reflective practice. In this commentary, we, three quantitative researchers who have grappled with the compatibility of reflexivity within our own research, argue that reflexivity has much to offer quantitative methodologists. The act of reflexivity prompts researchers to acknowledge and centre their own positionalities, encourages a more thoughtful engagement with every step of the research process, and thus, as we argue, contributes to the ongoing reappraisal of openness and transparency in psychology. In this paper, we make the case for integrating reflexivity across all research approaches, before providing a ‘beginner's guide’ for quantitative researchers wishing to engage reflexively with their own work, providing concrete recommendations, worked examples, and reflexive prompts.     

Behavioral case formulation: An experimental assessment study of transient tic disorder

A nine-year-old male, who met DSM III-R criteria for transient tic disorder, participated in an experimental assessment strategy to generate support for a case formulation. In addition to presenting motor disturbance, assessment procedures revealed six problem areas. All problems were formulated as manifestations of a hypersensitivity to evaluation, etiologically related to the boy's relationship with an insecure and critical father. It was hypothesized that the patient's tic disorder was a consequence of his hypersensitivity to father's excessive criticism, which then generalized to other evaluative situations. Using a controlled single-subject design, predictions derived from the formulation were tested by exposing the child to a planned combination of evaluative observers (e.g., father, mother, therapist, etc.) who watched him as he worked on a series of puzzles. The dependent measures included (1) behavioral recordings of tic frequency and (2) frontalis EMG responses. The results indicated significant differences in tic rate and EMG as a function of the type of observer. Consistent with the formulation, the patient displayed the highest levels of tic behavior and EMG response when his father was the observer and lowest in the presence of the mother. Predictions regarding other stimulus conditions were also confirmed. These results provided support for the case formulation that was used to design an effective treatment intervention. Findings suggest that the case formulation model offers a method whereby novel case hypotheses can be generated for poorly understood psychopathology and tested later in the experimental situation.     

Empirical research on the identification of singular,multiple and subordinate argumentation

To examine to what degree argumentation skills are mastered by pupils who attend the vocational, general and academic streams in Dutch secondary education various subtests were constructed. The theoretical study of argumentation as exposed by Van Eemeren and Grootendorst was the basis for this test construction. In this article tests for the identification of singular, multiple and subordinate argumentation are described. Also an account is given of a pretest of these three subtests.     

Cognitive habilitation in schizophrenia: A theoretical review and model of treatment

Evidence has accumulated for information processing deficits in schizophrenia. The functional significance of these deficits is only beginning to be understood. There are indications that these deficits may respond to intervention. Training on deficient functions has been demonstrated to relate to improvements in performance. A treatment program of cognitive rehabilitation is deduced from the literature and induced from clinical experience. The treatment is designed to impact directly on the information processing deficits of schizophrenic patients and indirectly to ameliorate functional deficits.     

Child and adolescent services research at the national institute of mental health: Research opportunities in an emerging field

This article describes an important new area of research on services for children and adolescents with mental disorders at the National Institute of Mental Health, the parameters of mental health services research for youth, and the opportunities that are available for grant-funded investigations in this area.     

Linking qualitative and quantitative methods in cross-cultural survey research: Techniques from cognitive science

Survey research with diverse cultural and ethnic minority groups is a complex and challenging endeavor that confronts the researcher with problems related to linguistic and conceptual equivalence and measurement as well as problems related to difficulties that respondents have with the sociocultural dimensions of the survey/interview process. One way to improve the quality of cross-cultural surveys and to insure that the findings are culturally relevant and accurate is to combine qualitative and quantitative methods. This paper proposes that certain qualitative techniques from cognitive science, specifically cognitive anthropology and cognitive psychology, are particularly well suited to being combined with survey research. These techniques provide information corresponding to the underlying thought processes of respondents and enable researchers to better understand how different cultural and ethnic groups construe the world. The information obtained can be used improve the formulation of survey questions, design and structure questionnaire formats to coincide with the way particular groups organize concepts, and help researchers understand difficulties respondents may have with the survey/interview process. In addition, the techniques produce data that are easily codifiable and more manageable than traditional qualitative techniques including participant observation and in-depth interviews.     

Brief report: Complex postformal thought in skilled research administrators

Expert research administrators responded to questions to determine to what degree they had postformal thinking skills. Postformal theory suggests that the interpersonal and institutional complexity of work roles would make them likely to exhibit postformal thought. The tests included a questionnaire about the use of postformal operations on the job, and thinking-aloud taped interviews of responses to job-related and standard postformal problems. The respondents demonstrated the use of postformal thinking operations on job-related tests and a more moderate degree of use on the standard problems. The results support prior research and our working hypothesis that a high degree of interaction with people and complex problems is associated with adults' postformal thought.     

Use and misuse of metrics in research evaluation

This paper addresses some critical issues in the applicability of quantitative performance measures (including bibliometric, economic, and co-occurrence measures) to the assessment of basic research. The strengths and weaknesses of metrics applied as research performance measures are examined. It is concluded that metrics have a useful role to play in the evaluation of research. Each metric employed, whether bibliometric, economic, co-occurrence, or others, brings a new dimension of potential insight to the complex problem of research assessment. However, when used in a stand-alone mode, metrics can be easily misinterpreted and result in misleading conclusions. Metrics should be an integral part of a more comprehensive approach to research evaluation, in which the leading role is assumed by expert peer review. Under this structure, the reviewers must be broadly constituted, so that the technical correctness of the research approaches being taken (doing the job right) can be evaluated by technical experts and the correctness of the research target (doing the right job) can be evaluated as well. This comprehensive approach insures quality in the implementation of existing research paradigms and allows the introduction of revolutionary new research paradigms as well. The views contained in this paper are solely those of the author and do not represent the views of the Department of the Navy. Ronald Kostoff received a Ph.D. from Princeton University, performed technical and economic research at Bell Laboratories, managed energy programs at U.S. Department of Energy, was Director of Technical Assessment at the Office of Naval Research for many years and presently manages the Navy’s In-House Laboratory Independent Research Program.