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The anti-stigma Opening Minds initiative (Mental Health Commission of Canada) identified the workplace as one of four critical areas for stigma evaluation and programming. Researchers found, however, that no validated tool to measure stigma in this context existed at the time. The purpose of the current research was to develop and assess the psychometric properties of a multi-component quantitative measure of public stigma towards mental illnesses in the workplace: Opening Minds Scale for Workplace Attitudes (OMS-WA). Three studies are discussed. Study 1 outlines the initial development of the OMS-WA, finding a five-factor structure with 23 items (EFA analysis; N = 207). Study 2 utilized employees from various businesses to further validate the OMS-WA, (N = 107), finding good internal consistency and good convergent/divergent validity. Study 3 utilized baseline data from two national large-scale stigma reduction and resiliency programs (first responders and general workplaces) to confirm the factor structure, finding good model fit and reliability with both samples (N = 5385; N = 1207). Together, these results provide strong evidence of the OMS-WA. Its use in measuring workplace stigma related to mental illness is recommended. Considerable future evaluation is warranted, and directions for generalizability studies, as well as suggestions for using the OMS-WA in intervention trials, are provided. [ABSTRACT FROM AUTHOR]

Resilience has been championed as important for mitigating stressors and challenges experienced by students during post-secondary education, as evidenced by the abundance of programs aimed at enhancing student resilience. Despite growing attention to resilience, there continues to be a lack of consensus about the definition or operationalization of the concept. Even less is known about how to foster resilience in the post-secondary context, especially for marginalized or underrepresented students, who are recognized to be at increased risk for negative mental health outcomes during their post-secondary education. To address these gaps, we employed qualitative methodology to explore marginalized or underrepresented students' perceptions of resilience. Findings demonstrated that resilience arises from a complex and dynamic interplay between personal skills and attitudes and resources available within students' communities. Post-secondary institutions are called to shift from individual student responsibility to a collective and shared responsibility for students' wellbeing in the face of adversity. [ABSTRACT FROM AUTHOR]

Adverse birth outcomes remain challenging public health problems in China. Increasing evidence indicated that prenatal depression and anxiety are associated with adverse birth outcomes, highlighting the importance and severity of prenatal depression and anxiety in China. The COVID-19 pandemic is likely to further exacerbate prenatal mental health problems and increase the risk of adverse birth outcomes. The aim of this study is to assess and compare the impacts of prenatal mental health issues on birth outcomes before and during the COVID-19 pandemic in Ma'anshan, Anhui, China. Participants in this study were women who visited local maternal and child health hospitals in Ma'anshan, Anhui, China. Two independent sets of individual maternal data (npre-pamdemic = 1148; npandemic = 2249) were collected. Prenatal depression and anxiety were measured online using the Edinburgh Postnatal Depression Scale (EPDS) and the General Anxiety Disorder-7 (GAD-7). Adverse birth outcomes were determined using hospital-recorded infant birth weight and gestational age at delivery. In this study, we found that the pandemic cohort had lower mean EPDS and GAD-7 scores than the pre-pandemic cohort. The prevalence of prenatal depression (14.5%) and anxiety (26.7%) among the pandemic cohort were lower than the pre-pandemic cohort (18.6% and 36.3%). No significant difference was found in the prevalence of adverse birth outcomes comparing the two cohorts. Prenatal depression was associated with small gestational age only in the pandemic cohort (OR = 1.09, 95% CI 1.00–1.19, p = 0.042). Overall, this study highlighted an association between prenatal depression and small for gestational age in Anhui, China. Addressing prenatal depression may thus be key in improving birth outcomes. Future studies could focus on potential causal relationships. [ABSTRACT FROM AUTHOR]

The negative affective priming (NAP) task is a behavioral measure of inhibition of emotional stimuli. Previous studies using the NAP task have found that individuals with depression show reduced inhibition of negative stimuli, suggesting that inhibition biases may play a role in the etiology and maintenance of depression. However, the psychometric properties of the NAP task have not been evaluated or reported. In the present study, we report data on the association between NAP task performance and depression symptoms in three independent samples, and we evaluate the internal consistency and test–retest reliability of the NAP effect indices. The NAP effect for both negative and positive target words had poor internal consistency in all three samples, as well as poor 2-week (Study 2) and 6-month (Study 3) test–retest reliability. The internal consistency and test–retest reliability of response times (RT) for the individual trial types were moderate to high, as were the intercorrelations between trial types. This pattern of results indicates that overall RT is reliable but variance in RTs for the different trial types in the NAP task is indistinguishable from variance in overall RT. Depression symptom severity was not associated with the NAP effect for negative or positive target words in any of the samples, which could be due to the poor reliability of the NAP effect. Based on these findings, we do not recommend that researchers use the NAP task as a measure of individual differences in the inhibition of emotional stimuli. [ABSTRACT FROM AUTHOR]

Objective: Worsening student mental health, along with more complex mental illness presentation and increased access to campus mental health services, has led to a mental health “crisis” on campuses. One way to address student mental health needs may be through mental health programs which have been found to increase resiliency and help-seeking, and reduce stigma. Participants: The effectiveness of The Inquiring Mind (TIM), a mental health promotion and mental illness stigma reduction program, was examined in 810 students from 16 Canadian post-secondary institutions. Methods and Results: Using a meta-analytic approach, TIM improved resiliency and decreased stigmatizing attitudes from pre to post, with medium effect sizes (d>.50). Analyses with those that completed the follow-up (about one-third of the sample) showed that effects were mostly retained at three months. Other outcomes also point to the program’s effectiveness. Conclusion: TIM appears to be an effective program for post-secondary students. However, additional research, including randomized control trials, is needed to address study limitations. [ABSTRACT FROM AUTHOR]

Mental health practitioners of cognitive and behaviour therapies (CBTs) have an ethical obligation to select evidence-based techniques. Little data are available on which techniques are used and whether technique use varies as a function of a therapist's theoretical orientation. The study explored the use of CBT techniques among a diverse sample of Australian mental health practitioners (MHPs). The focus was to assess the extent to which different CBT techniques are used in their practice. A mixed methods study was conducted with a large MHP sample who were taking part in a post-qualification CBT training course. Of the 2,086 MHPs, 41% (n = 864) reported using behaviourally focused techniques, and 49% (n = 1,032) reported using cognitively focused techniques. Self-described theoretical orientation could differentiate technique use. A diverse range of CBT techniques were reported by MHPs in the present study. The different ways MHPs used techniques put a spotlight on how different targets may be a focus of the same technique. What is already known about this topic: CBT remains the dominant training model of psychological therapies in Australian universities. The past few decades have witnessed an evolution in CBTs, regarding the diversification of techniques. It is unclear whether therapists use a broad array of CBT techniques in their everyday clinical practice and if that use varies as a function of theoretical orientation. What this topic adds: Australian Mental Health Professionals (MHPs) indicated that they use a diverse array of behaviourally focused and cognitively focused techniques in their practice. Self-identified theoretical orientation meaningfully differentiated from reported CBT technique use in practice. A range of emotional, behavioural and cognitive targets were reported by MHPs. [ABSTRACT FROM AUTHOR]

This article is part of a series on therapeutic relationships in cognitive behavioral therapy (CBT). It discusses the importance of client-therapist agreement in alliance ratings and how disagreement can negatively impact outcomes. The article also explores the influence of client factors, such as negative core beliefs, on the therapeutic relationship. Additionally, it examines therapist factors, including competence in facilitating homework and client engagement. The article concludes by emphasizing the need for further research on CBT-specific elements of the therapeutic relationship, such as collaborative empiricism and Socratic dialogue. [Extracted from the article]

The Dunning-Kruger (DK) effect is a form of meta-ignorance of knowledge (Kruger & Dunning, Journal of Personality and Social Psychology,77(6), 121–1134, 1999) that has not been explored regarding mental illness public stigma. The current study examined the DK effect in this field by comparing participants' actual stigma (measured by a social distance scale) and their perceived stigma (measured by a self-rating scale compared to their peers). In addition, the effectiveness of two types of feedback on stigma reduction was explored. Undergraduate participants (N = 393) with low actual public stigma perceived their public stigma level to be higher than it was, while those with high actual public stigma perceived it to be lower, supporting the DK effect. Generalized feedback did not reduce public stigma, whereas personalized feedback reduced public stigma for participants with high public stigma. This study revealed the existence of meta-ignorance in the field of mental illness public stigma and the effectiveness of personalized feedback. [ABSTRACT FROM AUTHOR]

Purpose: With the recent release of the National Standard for Mental Health and Well-Being for Post-Secondary Students, there is increased interest to integrate research and practice for mental health services on post-secondary campuses. Participant-oriented research is a useful framework to bridge this gap. This paper aims to describe the program development and evaluation process and reports challenges and lessons learned to inform future implementation strategies for similar endeavours. Design/methodology/approach: A participant-oriented research approach was used to revise and evaluate an innovative interdisciplinary resilience program, entitled Roots of Resiliency, for post-secondary students. Findings: This case analysis used the development and evaluation of Roots of Resiliency to demonstrate some of the strategies and challenges that exist for participant-oriented research related to mental health in the post-secondary context. Collaborative relationships among the various development team members contributed to an overall positive experience. Some challenges that others who work in post-secondary mental health field may consider include the need for content expertise, the ongoing need for communication among team members and the need for an effective system to give voice to all participants. Originality/value: Any mental health program has a cultural component and is best co-developed by the particular students (e.g. indigenous students) who are to be served by the program. In this regard, the co-design and shared development and evaluation of the current mental health program is an example that can be emulated in other programs within the post-secondary context. [ABSTRACT FROM AUTHOR]

Background: Baseline severity has emerged as a key predictor of acute response to treatments for depression. The goals of this individual patient data meta-analysis were to compare the relapse prevention effects of acute phase cognitive behavioral therapy (CBT) vs. acute phase antidepressant medications (ADM) either continued (-c) or discontinued (-d) and determine whether baseline depression severity moderated these effects. Methods: We included all available relevant randomized trials of CBT versus ADM in adult outpatients with depression. Cox proportional hazards models were used to examine whether treatment condition, baseline severity, and additional characteristics were associated with relapse. Results: Using individual participant data from 5 of 10 published trials (N = 341), CBT (HR = 0.38, 95% CI 0.26–0.57) and ADM-c (HR = 0.48, 95% CI 0.29–0.80) were superior to ADM-d in preventing relapse over 12 months but did not differ from each other (HR = 1.26, 95% CI 0.76–2.09). Baseline severity did not moderate these effects. Conclusions: Regardless of a patient's baseline symptom severity, CBT and ADM-c both prevent depressive relapse substantially better than medication discontinuation. Given the shorter duration of treatment and equivalent longer-term outcomes, treatment with CBT might be considered a first choice for adults with depression. [ABSTRACT FROM AUTHOR]

Objective: This study examined whether the working alliance mediated the effect of therapist competence on subsequent depression symptomology during Cognitive Behavioral Therapy (CBT). We also tested the potential moderation effect of alliance on subsequent depressive symptomology, based on participants' cognitive aptitude. Method: A total of 86 sessions were coded as the prediction interval across 50 patient-therapist dyads (age M = 39.22, SD = 8.78; 76% female). While accounting for prior depression, competence, and alliance levels, predictors were assessed early treatment (session 1; n = 45 sessions), mid-treatment (session 12; n = 41 sessions), and depressive symptomology was assessed at the subsequent session to the predictor assessments to investigate within-session variability of process variables. Results: Mediation analysis revealed that the effect of early treatment therapist competence on symptom change was mediated by alliance (indirect effect: β = −.17, 95% percentile bootstrap CI [−.32, −.01]). The positive association involving early treatment alliance and next session outcome was conditional upon low cognitive aptitude levels. Conclusions: Our result offers preliminary support for alliance as a mediator of the effect of competence, and that alliance-outcome relations vary as a function of client aptitude. These novel findings require replication and extension. [ABSTRACT FROM AUTHOR]

Background: The differential activation hypothesis (Teasdale & Dent, 1987) proposes that negative cognitions in individuals with a history of depression are activated more easily by negative mood than individuals without this history. The change of cognitions due to mood change was termed cognitive reactivity. Negative cognitions might exist on both explicit and implicit dimensions. Methods: This study examined the differential activation hypothesis on coping-related cognitions among people with a history of depression under different mood states in comparison with people who are currently depressed and those who have no history of depression. Coping-related cognitions were examined on both explicit and implicit dimensions. Currently depressed (n = 42), previously depressed (n = 61), and never depressed (n = 62) participants were tested on computer-based paradigms designed to measure depression, mood, and explicit and implicit cognitions. Results: Explicit negatively biased cognitions on coping existed among currently depressed individuals and to some extent among previously depressed individuals. Explicit cognitive reactivity existed among previously depressed individuals for emotional-related content. Implicit cognitive compensation tendency existed among currently depressed individuals on negative coping while implicit cognitive reactivity existed among previously depressed individuals on positive coping. Conclusions: This study demonstrated the existence of negatively biased cognitions and cognitive reactivity among people with a history of depression with coping-related contents, and on both explicit and implicit dimensions. The findings are consistent with the differential activation hypothesis. [ABSTRACT FROM AUTHOR]

Interpersonal and Therapist Factors in CBT The fourth study (Babl et al., [1]) examined community delivered CBT (an integrative model, I N i = 382) for personality disorders. This special section in I Psychotherapy Research i comprises three parts and examines various aspects of the therapeutic relationship within CBT. Generic/Common Relationship Elements In the context of Cognitive Behavior Therapy (CBT) the work of Aaron T. Beck and colleagues placed an emphasis on the therapeutic relationship as "necessary" for change (Beck et al., [2]). [Extracted from the article]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Psychosocial stress is associated with gambling urges and behavior. A large body of evidence also indicates that individuals who are at risk for disordered gambling are susceptible to attentional biases for gambling-related stimuli. Yet the extent to which psychosocial stress moderates these biases has not been fully investigated. The present study examined the effect of psychosocial stress on attentional biases for gambling stimuli in regular gamblers. The sample was 87 undergraduate students who were categorized according to gambling severity scores (no-risk, low-risk, moderate/high-risk). Participants viewed pairs of gambling-related and neutral images for 8 s while their eye movements were tracked and recorded to measure their attention to the images. Each group exhibited a unique pattern of attending to the images over the 8-s presentations. As predicted, the moderate/high-risk group exhibited an attentional bias for gambling-related images that sustained throughout the 8-s presentations. Psychosocial stress was found to moderate attentional biases only for the low-risk group. Psychosocial stress appears to influence attention toward gambling images only for low-risk gamblers. Our findings suggest that addressing underlying causes of stress in gamblers may be an effective method for reducing attentional biases to gambling stimuli and gambling problems and behaviors. [ABSTRACT FROM AUTHOR]

Background: This article discusses the concept of homework in cognitive-behavioral therapy (CBT), and reviews the articles in this special issue of Cognitive Therapy and Research. The article underscores the pivotal role of between- session activities and demonstrates that this role has been recognized for many years. Methods: This article reviews the articles from this special issue and uses them as a springboard to review other research and then discuss potential directions for future theory and research. Results: The initial research in this area focused on documenting the magnitude of the relationship between homework adherence and outcome in CBT. Research has now advanced to incorporate studies that examine issues such as homework competence, the complicated relationship between homework and other aspects of CBT such as the therapeutic relationship, and the use of technology to try to enhance homework completion and clinical outcomes. Conclusions: The use of homework assignments in CBT remains a critical issue for development. Limitations of the literature are addressed, and directions for future research in the field are provided. [ABSTRACT FROM AUTHOR]

Homework assignments are considered crucial to the generalization and maintenance of skills and cognitive reappraisal in cognitive behavior therapy (CBT). The present study examined the relationships among homework engagement (i.e., quantity and quality of adherence, taking into account task difficulties and obstacles), the theoretically meaningful determinants of engagement (i.e., client homework beliefs), therapist competence (i.e., in review, design, and planning of homework), and outcome in CBT for depression. Client factors (i.e., education level, marital status, and baseline depressive symptoms) were also examined as moderators of engagement-outcome relations. It was hypothesized that homework engagement would mediate the relationship between competence at one session and depressive symptoms at the next session. It was further hypothesized that homework beliefs would mediate the competence–engagement relationship. Independent observers assessed homework engagement, beliefs, and therapist competence in 50 client-therapist dyads, representing 233 sessions across five time points (sessions 3, 6, 9, 12, and 15). Cross-lagged panel analysis indicated no lagged competence–outcome effects and pooled multilevel analyses revealed no mediating effects of engagement or beliefs. However, higher client homework beliefs (more positive views) significantly predicted greater homework engagement. No evidence was obtained for hypothesized moderators. The present study is the first to examine specific homework beliefs as determinants of engagement. Findings underscore the importance of beliefs in understanding homework engagement, and provide avenues for future research. [ABSTRACT FROM AUTHOR]

Past research suggests that depressed individuals are less likely than non-depressed individuals to engage in mood-incongruent recall in response to negative mood and do not experience associated mood reparative effects. The present study examined the effects of adopting a reflective versus ruminative self-focus orientation towards one's mood on the valence of autobiographical memories recalled following a negative mood induction and the extent of mood repair following memory recall among individuals with varying depressive symptomatology. Participants underwent a negative mood induction and either a ruminative (n = 69) or reflective (n = 49) self-focus manipulation, and then recalled five specific autobiographical memories. Depression symptoms were associated with recall of less positive memories and reduced mood repair. The valence of recalled memories was associated with the extent of mood improvement, and depressive symptoms did not moderate this association. Contrary to our hypothesis, a reflective self-focus was not associated with recall of more positive memories or greater mood improvement than a ruminative self-focus. The results suggest that more depressed individuals are less likely to spontaneously engage in mood-incongruent recall in a negative mood state; however, recall of positive memories is associated with similar mood reparative effects regardless of depressive symptomatology. [ABSTRACT FROM AUTHOR]

Background: Mental health in China is a significant issue, and perinatal depression has been recognized as a concern, as it may affect pregnancy outcomes. There are growing calls to address China's mental health system capacity issues, especially among vulnerable groups such as pregnant women due to gaps in healthcare services and inadequate access to resources and support. In response to these demands, a perinatal depression screening and management (PDSM) program was proposed. This exploratory case study identified strategies for successful implementation of the proposed PDSM intervention, informed by the Consolidated Framework for Implementation Research (CFIR) framework, in Ma'anshan city, Anhui province.Methods: This qualitative study included four focus group discussions and two in-depth individual interviews with participants using a semi-structured interview guide. Topics examined included acceptance, utility, and readiness for a PDSM program. Participants included perinatal women and their families, policymakers, and healthcare providers. Interviews were transcribed verbatim, coded, and analyzed for emergent themes.Results: The analysis revealed several promising factors for the implementation of the PDSM program including: utilization of an internet-based platform, generation of perceived value among health leadership and decision-makers, and the simplification of the screening and intervention components. Acceptance of the pre-implementation plan was dependent on issues such as the timing and frequency of screening, ensuring high standards of quality of care, and consideration of cultural values in the intervention design. Potential challenges included perceived barriers to the implementation plan among stakeholders, a lack of trained human health resources, and poor integration between maternal and mental health services. In addition, participants expressed concern that perinatal women might not value the PDSM program due to stigma and limited understanding of maternal mental health issues.Conclusion: Our analysis suggests several factors to support the successful implementation of a perinatal depression screening program, guidelines for successful uptake, and the potential use of internet-based cognitive behavioral therapy. PDSM is a complex process; however, it can be successfully navigated with evidence-informed approaches to the issues presented to ensure that the PDSM is feasible, effective, successful, and sustainable, and that it also improves maternal health and wellbeing, and that of their families. [ABSTRACT FROM AUTHOR]

Public stigma of gambling disorder has negative effects on the mental health and functioning of affected individuals and impedes treatment-seeking. One factor thought to be implicated in stigma is the label used to describe the condition. The aims of this research were to: (1) evaluate whether different labels for problematic gambling behavior influence public stigma; and (2) compare public stigma of gambling disorder to other health conditions. Separate samples of university student (Study 1) and general population (Study 2) participants were randomly assigned to label conditions and completed questionnaires assessing stigma and attitudes towards the assigned label. In Study 1, the eight conditions included four gambling labels (problem gambling, pathological gambling, gambling disorder, and gambling addiction) and four psychiatric or health comparison labels (depression, obsessive-compulsive disorder, alcohol use disorder, and asthma). In Study 2, compulsive buying disorder was added as a fifth psychiatric comparison for a total of nine conditions. The results indicated that the four gambling label conditions elicited similar attitudes and stigma. Those conditions were also more stigmatized than the depression, obsessive-compulsive disorder, and asthma conditions. The gambling conditions elicited similar stigmatizing attitudes as alcohol use disorder but were slightly more stigmatized than compulsive buying disorder, with these conditions showing both similarities and differences across the stigma-related outcomes. The results were largely consistent across both samples and contribute to knowledge of the nature and origins of gambling-related stigma. [ABSTRACT FROM AUTHOR]

Objective: Individuals' use of self-statements reflecting self-criticism, a sense of inadequacy, and low self-worth has been linked to the incidence, severity, and recurrence of major depressive disorder [de Graaf, L. E., Huibers, M. J. H., Cuijpers, P., & Arntz, A. (2010). Minor and major depression in the general population: Does dysfunctional thinking play a role? Comprehensive Psychiatry, 51(3), 266–274. doi:10.1016/j.comppsych.2009.08.006; Riso, L. P., du Toit, P. L., Blandino, J. A., Penna, S., Dacey, S., Duin, J. S., ... Ulmer, C. S. (2003). Cognitive aspects of chronic depression. Journal of Abnormal Psychology, 112(1), 72–80. doi:10.1037/0021-843X.112.1.72]. The present study used an observer-rated measure, the Structural Analysis of Social Behavior [Benjamin, L. S. (1974). Structural Analysis of Social Behavior. Psychological Review, 81(5), 392–425. doi:10.1037/h0037024], to examine patients' self-directed communication over the course of psychotherapy. Method: Self-talk in early and late therapy sessions was examined using cases (N = 44) from the cognitive therapy arm of Jacobson and colleagues' component study of cognitive therapy for depression [Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., ... Prince, S. E. (1996). A component analysis of cognitive–behavioral treatment for depression. Journal of Consulting and Clinical Psychology, 64(2), 295–304. doi:10.1037/0022-006x.64.2.295, Jacobson, N. S., Dobson, K. S., Truax, P. A., Addis, M. E., Koerner, K., Gollan, J. K., ... Prince, S. E. (2000). A component analysis of cognitive–behavioral treatment for depression. Prevention & Treatment, 3(1). doi:10.1037/1522-3736.3.1.323a]. We identified changes at treatment termination, and used hierarchical multiple regression to examine whether improvements in patient self-talk influenced treatment outcome up to 24 months post-termination. Results: Trends indicate that patients used friendlier and less critical self-statements at the end of treatment. Decreased self-critical behaviour was associated with fewer symptoms at the end of treatment and up to one year later; increased self-acceptance was linked to symptom improvement a year and a half after termination. Conclusion: Consistent with cognitive theory, reduced self-criticism was associated with better treatment outcomes. Longer-term improvement was linked to the development of friendlier and more accepting self-referential behaviour. [ABSTRACT FROM AUTHOR]

The cognitive theory of depression proposes significant relations between negative thoughts and depression. Evidence for the model has been widely observed in Western countries. However, despite the high prevalence of depression in the Middle East (ME), there has been limited research that has evaluated the cognitive profiles of people living in this region, and especially in non‐Arab countries like Iran. The current research examined these relationships in Iran. Convenience sampling was used to recruit 80 depressed and 80 non‐depressed individuals via advertising in clinics and public areas, respectively. Depression status was checked with a structured interview, the Major Depressive Disorder subscale of the Psychiatric Diagnostic Screening Questionnaire, and the Beck Depression Inventory‐II. All participants completed the Automatic Thoughts Questionnaire‐Negative to examine the frequency of negative automatic thoughts. Unlike other results from Arab countries, depressed participants indicated significantly more negative thoughts towards self and future compared with the non‐depressed group. The results of the present study are consistent with the negativity hypothesis of the cognitive theory of depression. Further research is needed in the in ME, to investigate other hypotheses of this theory in this region. Strengths and limitations of the present study are discussed. [ABSTRACT FROM AUTHOR]

Scant research has investigated emotion regulation strategies in somatization disorder, despite its high comorbidity with depression and the growing interest in this topic in depression. The present study investigated emotion regulation strategies in patients with major depression and somatization disorder using clinical samples to examine common vulnerability factors and to provide evidence for difficulties in emotion regulation as transdiagnostic factors in these disorders. Patients with major depressive disorder (n = 30) and patients with somatization disorder (n = 30) completed measures of putatively adaptive and maladaptive emotion regulation strategy use. Patients with somatization disorder showed higher scores on measures of regulatory strategies, as measured by the sum of adaptive strategies in the Cognitive Emotion Regulation Questionnaire as well as the following subscales: positive refocusing, positive reappraisal, and refocusing on a plan. After controlling for levels of current depression, the significant effects remained for positive refocusing. Depression symptom severity was significantly and negatively correlated with most adaptive strategies and positively correlated with most maladaptive strategies. The current results provide preliminary data for a similar pattern of adaptive and maladaptive emotion regulation strategies usage in these two disorders. The results also contribute to theories of psychopathology and our understanding of critical cognitive and emotional processes. [ABSTRACT FROM AUTHOR]

Background and aims: Elevated impulsivity traits, particularly negative and positive urgency, have been identified as robust predictors of problem gambling. However, the mechanisms that link urgency to problem gambling remain unknown. The present research examined whether self-reported gambling motives (social, coping, enhancement, financial) mediated the association between urgency and problem gambling severity. Methods: The sample consisted of 564 community gamblers (52.1% female; M age =36.10, SD = 11.25) including 156 (27.7%) who were classified as moderate risk gamblers and 141 (25%) as problem gamblers. Results: The mediation analyzes revealed that both negative and positive urgency were associated with problem gambling severity. Coping was the only motive that mediated these associations. The pattern of results remained the same when the analyzes were restricted to problem gamblers and when controlling for days gambled and money spent in the past 30 days. Conclusions: The desire to alleviate strong emotional states (negative or positive) maybe an important determinant of problem gambling. Furthermore, results indicate that treatment initiatives for problem gambling may benefit from including training for clients in alternative and more adaptive coping strategies for the effective management of intense affective states. [ABSTRACT FROM AUTHOR]

The first part examined general aspects of the therapeutic alliance in CBT, together with critical interpersonal and therapist factors that facilitate outcome. I Psychotherapy Research i has supported a tripartite Special Section related to the therapeutic relationship within cognitive behavioral therapy (CBT). [Extracted from the article]

Police agencies increasingly implement training programs to protect mental health. The Road to Mental Readiness (R2MR) program was designed by the Canadian military to increase mental health resilience. A version of R2MR was adapted for municipal police by the Mental Health Commission of Canada (MHCC). The current research was designed to assess the R2MR program, as adapted and delivered by the MHCC, in a municipal police sample. Participants were 147 Canadian police agency employees (57% women) who received a single R2MR training session. Participants completed pre- and post-training self-report questionnaires, and follow-ups at 6 and 12 months. The questionnaires assessed mental health symptoms, work engagement, resiliency, mental health knowledge, and stigma. Multilevel modeling analyses assessed for within-participant changes over time. The results were consistent with other single session interventions; specifically, there were no significant changes in mental health symptoms, resilience, or work engagement (p >.05). There were small, but significant (p <.05), reductions in stigma at post-training that may facilitate help-seeking among police; relatedly, in open-ended response fields, participants commonly described the training as helpful for changing attitudes and improving communication. More engagement with the material may produce larger, sustained gains, but more published research is critically needed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Interpersonal theories suggest that cohesion between two individuals can be described by the degree to which they communicate harmoniously or, the complementarity, of their interactions (Gurtman, 2001; Kiesler, 1996). Friendly complementarity within therapy dyads is linked to both alliance and treatment outcome (Kiesler & Watkins, 1989; von der Lippe, Monsen, Rønnestad & Eilertsen, 2008; Samstag et al., 2008; Tracey, Sherry & Albright, 1999). Aim: The purpose of this study was to identify complementarity patterns that may help or hinder the effectiveness of cognitive therapy (CT) for depression. Method: The Structural Analysis of Social Behavior (Benjamin, 1974) was used to code CT sessions for individuals with depression. Dyads (N = 16) were divided into high‐ and low‐change groups. Lag Sequential Analysis (Sackett, 1979) was used to analyse first order sequences in client and therapist interpersonal behaviour. Findings: As expected, complementarity was better among high‐change dyads for affiliative behaviour. Low‐change dyads demonstrated stronger patterns of complementarity along the autonomy axis. Conclusion: This preliminary investigation illustrates different communication patterns among high‐ and low‐change dyads. Implications for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Cognitive and interpersonal variables are often understood to be related to the etiology and maintenance of major depression. However, few studies have examined the relationship between these two constructs. Aim: This study examined the association between cognitive errors (CEs) most commonly endorsed among individuals with major depressive disorder (MDD) and their interpersonal functioning. Method: These processes were examined early in psychotherapy and at the end of 20 sessions of cognitive behavioral therapy for depression. Therapy transcripts of 42 clients with MDD were rated for CEs using the Cognitive Error Rating Scale (CERS: Drapeau, Perry & Dunkley, 2008) and for interpersonal behaviors using the Structural Analysis of Social Behavior (SASB: Benjamin & Cushing, 2000). Findings: Results of this study revealed significant associations between CEs and interpersonal behaviors early in treatment and at the end of treatment. Implications of these findings are discussed in the context of improving psychotherapy process and outcome. [ABSTRACT FROM AUTHOR]

Therapist competence is an important factor in treatment integrity. This study reports on a direct comparison of the original Cognitive Therapy Scale (CTS) with the revised version, the Cognitive Therapy Scale-Revised (CTS-R), as observational instruments designed to evaluate therapist competence in a completed trial of Cognitive Behavior Therapy (CBT) for depression. Treatment sessions (N = 94) from 50 depressed participants (M age = 39.2 years, 76% female, with an average of 5.9 depressive episodes) were evaluated on the CTS and CTS-R by trained independent observers who were blind to treatment outcome, as well as to subject, and session numbers. A comprehensive training program and inter-rater reliability monitoring protocol were employed. Two models were used to compare CTS and CTS-R in relation to change in depression symptoms at termination, 12 and 24 month follow-up while controlling for pre-treatment depression levels and working alliance. Both the CTS and CTS-R demonstrated comparable internal reliability, interrater reliability, and when assessed in early treatment phase, both predicted a statistically significant reduction in depressive symptomatology at termination. No significant competence-outcome relations were detected with late CTS and CTS-R ratings, and the significant positive interaction terms indicated relations with depressive symptomatology were not maintained at follow-up. Given these findings, we encourage future research to examine specific competence domains and “therapist drift” with an increased number of session assessments. [ABSTRACT FROM AUTHOR]

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Adverse childhood experiences (ACEs), such as sexual and physical abuse, have been established as risk factors for the development of disordered gambling. The underlying mechanism by which ACEs influence disordered gambling, however, remains unknown. The aims of the present research were to comprehensively investigate ten types of childhood adversity and their relationships to disordered gambling in adulthood, and to test whether emotion dysregulation mediated the relationship between ACEs and disordered gambling. A sample of community gamblers (N = 414) completed self-report measures of ACEs, emotion dysregulation, and gambling severity. Results revealed a significant association between all but one type (physical abuse) of ACEs and disordered gambling. Further, the results highlighted the cumulative impact of ACEs on gambling. Specifically, individuals who experienced three or more types of ACEs were more than three times as likely to report disordered gambling as compared to individuals with no history of childhood adversity. Importantly, as hypothesized, emotion dysregulation mediated the relationship between ACEs and disordered gambling. Findings from this research describe the association between ACEs and gambling and indicate a causal link between childhood adversity and disordered gambling. Results suggest that treatment initiatives may do well to address both ACEs and emotion dysregulation in the treatment of problem gambling. [ABSTRACT FROM AUTHOR]

Introduction: Models of depression that arise in the West need to be examined in other regions of the world. This study examined a set of foundational hypotheses generated by Beck’s cognitive model of depression among depressed individuals in Egypt and Canada. Method: We recruited 29 depressed and 29 non-depressed Egyptians and compared their results with those of 35 depressed and 38 non-depressed Canadians. Depression status was ascertained using a structured interview, scores on the Beck Depression Inventory, and scores on the Psychiatric Diagnostic Screening Questionnaire. Participants completed questionnaires designed to measure the frequency of negative and positive automatic thoughts (ATQ–N, BHS, and ATQ–P), and dysfunctional attitudes (DAS). Results: Depressed individuals in both countries had significantly more negative thoughts about self and future, greater frequency of dysfunctional attitudes, and diminished positive self-thoughts in comparison to non-depressed individuals. Egyptians generally showed significantly more dysfunctional attitudes than their Canadian counterparts. Discussion: The four hypotheses that were tested were supported among the depressed Egyptian sample, which is consistent with the cognitive model. Implications for the cognitive-behavioral model and treatment for this group of sufferers are discussed. [ABSTRACT FROM AUTHOR]

Cognitive therapy (CT) aims to treat major depression symptomatology by restructuring the patients' cognitive distortions to more adaptive thinking patterns. This study examined changes in cognitive errors (CEs) as patients undergo CT for depression. Forty-five participants were assessed at early and late therapy for CEs using the Cognitive Errors Rating System (Drapeau, Perry, & Dunkley, 2008) and for depression using the Beck Depression Inventory (A. T. Beck, Rush, Shaw, & Emery, 1979). Although the total number of CEs did not change from early to late therapy, negative CEs significantly decreased, and positive CEs increased. Recovered participants had fewer total CEs, negative CEs, and negative overgeneralization than nonrecovered participants. Depressive symptoms were inversely related to late therapy positive CEs among the nonrecovered participants. Research and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Major depression is among the most common comorbid conditions in problem gambling. However, little is known about the effects of comorbid depression on problem gambling. The present study examined the prevalence of current major depression among problem gamblers (N = 105) identified from a community sample of men and women in Alberta, and examined group differences in gambling severity, escape motivation for gambling, family functioning, childhood trauma, and personality traits across problem gamblers with and without comorbid depression. The prevalence of major depression among the sample of problem gamblers was 32.4%. Compared to problem gamblers without depression (n = 71), problem gamblers with comorbid depression (n = 34) reported more severe gambling problems, greater history of childhood abuse and neglect, poorer family functioning, higher levels of neuroticism, and lower levels of extraversion, agreeableness, and conscientiousness. Furthermore, the problem gamblers with comorbid depression had greater levels of childhood abuse and neglect, worse family functioning, higher neuroticism, and lower agreeableness and conscientiousness than a comparison sample of recreational gamblers with depression (n = 160). These findings underscore the need to address comorbid depression in assessment and treatment of problem gambling and for continued research on how problem gambling is related to frequently co-occurring disorders such as depression. [ABSTRACT FROM AUTHOR]

Although research examining the stigma of mental disorders is burgeoning, there has been little research exploring the personality and individual differences that may be associated with mental disorders stigma. The current study examined the relation between stigma toward mental disorders and social-psychological individual difference variables (intergroup anxiety, empathic concern, perspective taking, and modern prejudice toward people with mental disorders). As well, the Big Five and Honesty-Humility personality traits were examined at factor- and facet-levels to replicate and extend previous research that has examined their relations with stigma. The social-psychological individual difference variables were significantly correlated with mental disorders stigma. More interestingly, regression models indicated that intergroup anxiety, empathic concern, and modern prejudice accounted for more variance in the prediction of stigma than Big Five factors and facets. Additionally, results indicate the utility of examining factor- and facet levels, rather than only the factor level. These results highlight the need to further examine individual characteristics and personality in stigma research. To conclude, the current findings are discussed in the context of interventions aimed at reducing the stigma of mental disorders. [ABSTRACT FROM AUTHOR]

The cognitive model of depression posits that depressed individuals harbor more dysfunctional self-referent attitudes, but little is known about how depressed individuals perceive the attitudes and perceptions of others in their social arena. This study examined whether dysphoric individuals perceive others to hold equally negative attitudes about themselves, and whether such perceptions depend on sociotropic (i.e., highly invested in social approval and relationship success) and autonomous (i.e., highly invested in vocational or academic achievement and goal attainment) personality styles. A sample of undergraduate students (N= 197) was recruited, and after the assessment of their depression symptoms and personality style, participants read vignettes that described negative scenarios, and imagined that these scenarios occurred to themselves or the general university student. After reading each vignette, participants also rated their agreement with a number of statements that assessed dysfunctional attitudes. Results indicated that elevated dysphoria (i.e., showing signs of depression) scores were positively associated with dysfunctional self-referent attitudes. Further, moderational analyses examining the interaction of sociotropy and dysphoria did not support the hypothesis that individuals higher on dysphoriaandsociotropy were less likely to perceive others as harboring negative attitudes about themselves in comparison to those with elevated dysphoria and lower levels of sociotropy. Last, individuals showing elevated dysphoriaandhigher scores on subdomains of autonomy were more likely to perceive others as exhibiting negative attitudes about themselves than those with low levels of the trait. These findings, their implications, and strengths and limitations of the current investigation are further discussed. [ABSTRACT FROM PUBLISHER]

Background: There is a role for brief assessment instruments in detection and management of major depression in MS. However, candidate scales have rarely been validated against a validated diagnostic interview. In this study, we evaluated the performance of several candidate scales: Patient Health Questionnaire (PHQ)- 9, PHQ-2, Center for Epidemiologic Studies Depression rating scale (CES-D), and Hospital Anxiety and Depression Scale (HADS-D) in relation to the Structured Clinical Interview for DSM-IV (SCID). Methods: The sample was an unselected series of 152 patients attending a multiple sclerosis (MS) clinic. Participants completed the scales during a clinic visit or returned them by mail. The SCID was administered by telephone within two weeks. The diagnosis of major depressive episode, according to the SCID, was used as a reference standard. Receiver-operator curves (ROC) were fitted and indices of measurement accuracy were calculated. Results: All of the scales performed well, each having an area under the ROC > 90%. For example, the PHQ-9 had 95% sensitivity and 88.3% specificity when scored with a cut-point of 11. This cut-point achieved a 56% positive predictive value for major depression. Conclusions: While all of the scales performed well in terms of their sensitivity and specificity, the availability of the PHQ-9 in the public domain and its brevity may enhance the feasibility of its use. [ABSTRACT FROM AUTHOR]

Empirical research has increasingly focused on interpersonal variables associated with the development and maintenance of depression. This article outlines some key interpersonal risk factors for depression, including anxious attachment, sociotropy, excessive reassurance seeking, interpersonal stress generation, reduced social support, social skills deficits, and social avoidance. Recommendations are made for how cognitive-behavioural therapy may be adapted to address such factors. Specifically, suggestions are offered for how cognitive and behavioural interventions, such as cognitive restructuring, behavioural activation, behavioural experiments, and skills training, may be used with depressed clients to promote positive relationships and reduce maladaptive interpersonal behaviours. [ABSTRACT FROM AUTHOR]

Objectives This study identified and examined a set of potential predictors of self-reported negative mood following a depressive mood induction procedure ( MIP) in a sample of previously depressed, clinically anxious, and control participants. The examined predictor variables were selected on the basis of previous research and theories of depression, and included symptoms of depression and anxiety, negative and positive affect, negative and positive automatic thoughts, dysfunctional beliefs, rumination, self-concept, and occurrence and perceived unpleasantness of recent negative events. Methods The sample consisted of 33 previously depressed, 22 currently anxious, and 26 non-clinical control participants, recruited from community sources. Participant group status was confirmed through structured diagnostic interviews. Participants completed the Velten negative self-statement MIP as well as self-report questionnaires of affective, cognitive, and psychosocial variables selected as potential predictors of mood change. Results Symptoms of anxiety were associated with increased self-reported negative mood shift following the MIP in previously depressed participants, but not clinically anxious or control participants. Increased occurrence of recent negative events was a marginally significant predictor of negative mood shift for the previously depressed participants only. None of the other examined variables was significant predictors of MIP response for any of the participant groups. Conclusions These results identify factors that may increase susceptibility to negative mood states in previously depressed individuals, with implications for theory and prevention of relapse to depression. The findings also identify a number of affective, cognitive, and psychosocial variables that do not appear to influence mood change following a depressive MIP in previously depressed, currently anxious, and control individuals. Limitations of the study and directions for future research are discussed. Practitioner points Current anxiety symptomatology was a significant predictor and occurrence of recent negative events was a marginally significant predictor of greater negative mood shift following the depressive mood induction for previously depressed individuals., None of the examined variables predicted change in mood following the depressive mood induction for currently anxious or control individuals., These results suggest that anxiety symptoms and experience with negative events may increase risk for experiencing depressive mood states among individuals with a vulnerability to depression., The generalizability of the present results to individuals with comorbid depression and anxiety is limited., Future research employing appropriate statistical approaches for confirmatory research is needed to test and confirm the present results. [ABSTRACT FROM AUTHOR]

Depression is thought to be characterised by impaired emotion regulation, although the mechanisms of that regulation are not yet well understood. The present study examined trait, spontaneous and instructed emotion regulation in dysphoric (n= 66) and non-dysphoric (n= 86) participants. Participants were randomly assigned to use reappraisal while watching a sadness-inducing film clip (instructed emotion regulation condition) or were not given specific viewing instructions (spontaneous emotion regulation condition). Participants also completed trait measures of emotion regulation. Dysphoric individuals reported greater spontaneous use of rumination and suppression than non-dysphoric individuals, and these strategies were associated with greater negative emotional reactivity to the sadness-inducing film clip. Both participant groups were able to effectively use reappraisal when instructed to do so. The clinical implications of these findings and future research directions are discussed. [ABSTRACT FROM PUBLISHER]

Aim:The finding by Jacobson and colleagues that there was no difference in treatment outcome for individuals treated with a complete cognitive therapy (CT) package and those receiving behavioural activation raised serious concerns about the mediational role of cognition in depression. The present study was designed to test whether the interaction between coping and cognition predicts changes in depressive symptomatology.Method:The sample (N=30) was derived from the full CT condition of the study conducted by Jacobson and colleagues. Therapy transcripts from the third session were rated to assess cognitive errors and coping. Change in depression scores from pre-treatment to post-treatment was computed.Findings:Analyses demonstrated that engagement in self-reliance and not engaging in escape coping predicted greater decreases in levels of depression after CT.Implications for practice:These findings suggest that engaging in specific types of adaptive coping strategies and avoiding maladaptive coping may be important in predicting decreases in depression for individuals who have high levels of certain cognitive errors. [ABSTRACT FROM AUTHOR]