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This study examined mechanisms by which social cognitive theory (SCT) interventions influence health outcomes and the importance of involving partners in recovery following the patients' receipt of an initial implantable cardioverter defibrillator (ICD). We compared direct and indirect intervention effects on patient health outcomes with data from a randomized clinical trial involving two telephone-based interventions delivered during the first 3 months post-ICD implant by experienced trained nurses: P-only conducted only with patients, and P + P conducted with patients and their intimate partners. Each intervention included the patient-focused component. P + P also included a partner-focused intervention component. ICD-specific SCT-derived mediators included self-efficacy expectations, outcome expectations, self-management behavior, and ICD knowledge. Outcomes were assessed at discharge, 3- and 12-months post ICD implant. Patients (N = 301) were primarily Caucasian, male, 64 (± 11.9) years of age with a mean ejection fraction of 34.08 (± 14.3). Intervention effects, mediated through ICD-specific self-efficacy and outcome expectations, were stronger for P + P compared to P-only for physical function (β = 0.04, p = 0.04; β = 0.02, p = 0.04, respectively) and for psychological adjustment (β = 0.06, p = 0.04; β = 0.03, p = 0.04, respectively). SCT interventions show promise for improving ICD patient physical and psychological health outcomes through self-efficacy and outcome expectations. Including partners in post-ICD interventions may potentiate positive outcomes for patients. Trial registration number (TRN): NCT01252615 (Registration date: 12/02/2010) [ABSTRACT FROM AUTHOR]

BackGround: Studies on feedback in youth mental health care are scarce and implementation of feedback into clinical practice is problematic. Objective: To investigate potentially effective components of feedback from Routine Outcome Monitoring (ROM) in youth mental health care in the Netherlands through a three-arm, parallel-group, randomized controlled trial in which a literature-based, multi-faceted implementation strategy was used. Method: Participants were randomly allocated to three conditions (basic feedback about symptoms and quality of life; basic feedback supplemented with clinical support tools; discussion of the feedback of the second condition with a colleague while following a standardized format for case consultation) using a block randomization procedure, stratified by location and participants' age. The youth sample consisted of 225 participants (mean age = 15.08 years; 61.8% female) and the parent sample of 234 mothers and 54 fathers (mean age of children = 12.50 years; 47.2% female). Primary outcome was symptom severity. Secondary outcomes were quality of life and end-of-treatment variables. Additionally, we evaluated whether being Not On Track (NOT) moderated the association between condition and changes in symptom severity. Results: No significant differences between conditions and no moderating effect of being NOT were found. This outcome can probably be attributed to limited power and implementation difficulties, such as infrequent ROM, unknown levels of viewing and sharing of feedback, and clinicians' poor adherence to feedback conditions. Conclusions: The study contributes to our limited knowledge about feedback from ROM and underscores the complexity of research on and implementation of ROM within youth mental health care. Trial registration Dutch Trial Register NTR4234. [ABSTRACT FROM AUTHOR]

Rates of subclinical symptoms and full-blown depression signifcantly increase during adolescence. Hence, understanding how multiple cognitive risk factors are related to depression in adolescence is of major importance. For this purpose, we simultaneously considered multiple cognitive vulnerabilities, as proposed by three major cognitive theories for depression, namely Beck’s cognitive theory, hopelessness theory, and response style theory. In this four-wave study, we investigated the architecture, interplay, and stability of cognitive vulnerability mechanisms, depressive symptoms, and stressors in a large group of adolescents over a period of one year (n=469; mean age=15 years; 64% female). Network analysis was used to shed light on the structure of cognitive vulnerabilities in a data-driven fashion. Analyses revealed that diferent cognitive vulnerabilities were intertwined and automatic thoughts played the role of hub node in the network. Moreover, the interplay among cognitive vulnerabilities and depressive symptoms was already markedly stable in adolescence and did not change over a 12-month period. Finally, no evidence was found that cognitive vulnerabilities interacted with stressors, as proposed by diathesis-stress models. These fndings advance our understanding of multiple cognitive risk factors for depression in adolescence. [ABSTRACT FROM AUTHOR]

Each year, many important articles are published that make valuable contributions to the field of psychotherapy. It is helpful to remain informed about recent developments in the field, and respect the useful refinements that are being proposed in various journal articles. Unfortunately, with so many journals in the field, it can be challenging to find the best articles, and some important papers may be overlooked. In recent years, the situation has become even worse with the expansion of many new and often predatory journals, publishing inferior papers. The Journal of Contemporary Psychotherapy awards program has two main goals. First, the review of the recent literature helps to highlight the useful papers published during the previous year. Second, the awards program helps to praise the best and inspire the rest, aiming to motivate the field to publish high quality papers. The awards selection process involved a review of numerous academic articles published during 2018 in 60 different professional journals. Then, a panel of judges reviewed 52 finalists for ten possible awards. Adequate agreement was found to provide awards for nine different categories of research studies or review articles. Each winning paper is reviewed, and most authors provide a behind-the-scenes look at the work involved in their valuable contribution to the field of psychotherapy. [ABSTRACT FROM AUTHOR]

The dorsolateral prefrontal cortex, globus pallidus, and nucleus accumbens are important components of the reward circuit in the brain; and prior research suggests individuals with damage to these regions feel less pleasure (i.e., are anhedonic). However, little is known about how these brain regions relate to vicarious pleasure. Pilot fMRI data were collected from 20 participants (Mage = 22, SD = 7.0, 63% female) during a validated empathy induction paradigm that utilized video clips extracted from the television show "Extreme Makeover: Home Edition" to elicit empathic happiness (i.e. vicarious happiness) when targets display positive affect, and either empathic cheerfulness (i.e. the tendency to want to cheer someone up) or empathic concern (i.e. vicarious sadness) when targets display negative affect. Participants also completed the novel "Happy Faces" task-a behavioral measure of anhedonia-while fMRI was collected. fMRI data during task completion were used to predict trait empathy measured via self-report outside of the scanner, and accuracy on the "Happy Faces" task. Results indicate that globus pallidus activity during empathic concern-eliciting video clips significantly predicted self-reported trait empathic cheerfulness (R2 = 26%, p = 0.045). Furthermore, greater dorsolateral prefrontal cortex (DLPFC) activity during the Happy Faces task predicted accurate performance on the task (R2 = 34%, p < .05); and greater nucleus accumbens shell activity during the Happy Faces task predicted greater trait empathic happiness (R2 = 38%, p < .05). These results suggest that fronto-striatal circuitry contributes to our experience of anhedonia, empathic happiness, and empathic cheerfulness. [ABSTRACT FROM AUTHOR]

Depressive rumination has been strongly linked to the development and maintenance of depression; however, less attention has been paid to ruminative processes in response to positive affect, and fewer have examined these processes in daily life. The current study sought to address these gaps by exploring depressive rumination and two forms of responses to positive affect, dampening and positive rumination, under ecologically valid conditions using daily diary methodology. One hundred fifty-seven young adults completed 14-day end-of-day diaries assessing positive affect and depressive symptoms in relation to depressive rumination, responses to positive affect, and daily positive and negative events. Daily depressive rumination predicted stronger associations between negative events and daily depressive symptoms. Higher daily dampening was associated with higher daily depressive symptoms and decreased positive affect and predicted lower associations between daily positive events and improvements in mood (including reduced daily positive affect and increased daily depressive symptoms). Higher daily positive rumination was negatively associated with daily depressive symptoms and interacted with daily positive events such that positive rumination had a greater impact on depressed mood on days when positive experiences were low. Results indicate that both depressive rumination and responses to positive affect play a role in influencing daily mood and depressive symptoms. [ABSTRACT FROM AUTHOR]

Traditionally, treatments for depression have been primarily focused on reducing patients' symptoms or deficits and less concerned with building positive resources. This study aims to compare the efficacy of a manualized protocol of empirically-validated positive psychology interventions (PPI) with a cognitive-behavioral therapy (CBT) protocol. This controlled clinical trial included 96 adult women with a DSM-IV diagnosis of major depression or dysthymia. Participants were blindly allocated to a 10-session PPI ( n = 47) or CBT ( n = 49) group therapy condition. Intention to treat analysis showed that both interventions were effective in reducing clinical symptoms and increasing well-being. There were no significant differences between groups in either main outcomes (i.e., severity of depressive symptoms and clinical diagnosis) or secondary outcomes (e.g., positive and negative affect, and satisfaction with life). Even within the most severely depressed participants, no differences between PPI and CBT emerged. If further clinical studies confirm these results, this would widen treatment choice for both patients and professionals. [ABSTRACT FROM AUTHOR]

Experience sampling methodology (ESM) was used in a randomized controlled trial of short-term therapy to examine changes in daily affect and reactivity to daily event appraisals among depressed patients. Fifty-five depressed adults (mean age 37 years, 80 % female) were randomly assigned to one of two therapy conditions. Using an interactive voice response system, participants rated activities and emotional functioning eight times per day for 7 days. Twenty-nine participants completed treatment and repeated ESM at post-treatment. Broad improvements in mood, cognition, and physical functioning were similar across treatment conditions, with the largest improvements for markers of positive affect. Participants demonstrated increased resilience, i.e., diminished reactivity to stressors, at post-treatment. Changes in reactivity to positive daily situations were minimal. Findings underscore the utility of ESM in psychotherapy research and the importance of including measures of both positive and negative affect and experiences. [ABSTRACT FROM AUTHOR]

Depression is a developmental phenomenon with significantly increasing rates during adolescence. As Beck's cognitive model of depression has been commonly accepted to explain the development and maintenance of depression, it is crucial to understand how and when cognitive vulnerabilities predicted in this model begin to interact. Three sequential interpretations of this model were compared. The causal mediational interpretation identifies dysfunctional attitudes as most distal to depressive symptoms, followed by cognitive errors, cognitive triad, and negative automatic thoughts, with each construct successively more proximal to depressive symptoms. In the symptom model the causal chain is reversed, with depressive symptoms as the most distal construct, followed by negative automatic thoughts, the cognitive triad, cognitive errors, and then dysfunctional attitudes. The bidirectional model merges both interpretations in which the activation of cognitive constructs causes the development of depressive symptoms which in turn trigger and reinforce already existing dysfunctional attitudes. Further, while Beck's model of depression proposes full mediation, empirical studies identified repeatedly partial mediations. Thus, the causal meditational, the symptoms, and the bidirectional model were each tested as full and partial mediation models. Finally, sex differences in the associations between variables were studied. In the 3-wave longitudinal study, 518 high school students (62.7 % female, average age: 15.09 years) completed questionnaires measuring all mentioned elements of Beck's model. The bidirectional model with partial mediation fits the data best. Cognitive errors emerged as the main mediator in the bidirectional model with partial mediation and significant sex differences in the strengths of associations were identified. The findings demonstrate the relevance of adolescence as developmental period during which the examined associations develop into the network they form in adulthood. Further, psychological interventions focusing on cognitive errors promise to be most effective. [ABSTRACT FROM AUTHOR]

Objectives: To determine the role of flexible goal adjustment in the impact of informal caregiving on depressive symptoms, using a longitudinal approach.Method: Data were gathered from the German Ageing Survey. This is a population-based longitudinal study among community-dwelling individuals aged 40 and above in Germany. Data were derived from the second (2002), third (2008) and fourth (2011) wave, drawing on 10,994 observations. Flexible goal adjustment was assessed using a scale by Brandstädter and Renner. Informal caregiving was measured by asking the individuals whether they provide informal care. Depressive symptoms were quantified by using the Center for Epidemiological Studies Depression scale.Results: Adjusting for several potential confounders, fixed effects regressions showed that the onset of informal caregiving markedly increased depressive symptoms. Furthermore, regressions revealed that this effect was significantly moderated by flexible goal adjustment.Discussion: Our results highlight the importance of informal caregiving for depressive symptoms. Furthermore, the importance of flexible goal adjustment in the relation between informal caregiving and depressive symptoms should be emphasized. Efforts to increase flexible goal adjustment might be beneficial in reducing depressive symptoms among informal caregivers. [ABSTRACT FROM AUTHOR]

Blunted positive affect is characteristic of depression. Altered positive affect regulation may contribute to this blunting, and two regulation strategies, dampening positive affect and positive rumination, have been implicated in depression. However, the conditions under which these strategies impart risk/protective effects prior to onset of depression are unknown. The current study examined 81 healthy children (age 7-10) at low and high risk for depression on the basis of maternal history of depression and tested how dampening and positive rumination interacted with the experience of recent positive life events to predict depressive symptoms. Children at high and low risk did not differ in their use of dampening or positive rumination. However, elevated use of dampening in the context of many positive life events predicted current depressive symptoms, and specifically anhedonic symptoms, in children at low-risk for depression. These findings held when controlling for negative rumination and negative life events. Positive rumination did not interact with positive life events but was associated with higher depressive symptoms in high-risk children. Results indicate that prior to the onset of depression, positive life events may impart risk when dampening positive affect is utilized in this context, while positive rumination may increase risk for depressive symptoms. [ABSTRACT FROM AUTHOR]

Self-regulation models of psychopathology provide a theory-based, empirically supported framework for developing psychotherapeutic interventions that complement and extend current cognitive-behavioral models. However, many clinicians are only minimally familiar with the psychology of self-regulation. The aim of the present manuscript is twofold. First, we provide an overview of self-regulation as a motivational process essential to well-being and introduce two related theories of self-regulation which have been applied to depression. Second, we describe how self-regulatory concepts and processes from those two theories have been translated into psychosocial interventions, focusing specifically on self-system therapy (SST), a brief structured treatment for depression that targets personal goal pursuit. Two randomized controlled trials have shown that SST is superior to cognitive therapy for depressed clients with specific self-regulatory deficits, and both studies found evidence that SST works in part by restoring adaptive self-regulation. Self-regulation-based psychotherapeutic approaches to depression hold significant promise for enhancing treatment efficacy and ultimately may provide an individualizable framework for treatment planning. [ABSTRACT FROM AUTHOR]

ᅟ: Breast cancer survivors (BCS) have been told in the past to avoid strenuous repetitive activities in order to decrease the risk of lymphedema development. Recent evidence suggests that exercise may be beneficial to decrease the signs/symptoms and development of lymphedema.Purpose/methods: This study assessed the arm circumferences of 27 BCS (64 ± 7 years) at baseline and every 2 weeks thereafter during a 6-month resistance exercise training (RT) intervention. RT consisted of 2 days/week of 10 exercises including two sets of 8-12 repetitions at 52-69 % of the participants' one-repetition maximum.Results: A repeated measure analysis of variance revealed no significant changes in percent difference of arm circumferences at any assessment point (pre, 1.31 ± 6.21 %; post, 0.62 ± 6.55 %), nor were there any adverse lymphedema-related events reported during the study.Conclusions: These findings imply that RT can be a safe activity for women with or at risk for breast cancer-related lymphedema. [ABSTRACT FROM AUTHOR]

The original cognitive-behavioural (CB) model of bulimia nervosa, which provided the basis for the widely used CB therapy, proposed that specific dysfunctional cognitions and behaviours maintain the disorder. However, amongst treatment completers, only 40-50 % have a full and lasting response. The enhanced CB model (CB-E), upon which the enhanced version of the CB treatment was based, extended the original approach by including four additional maintenance factors. This study evaluated and compared both CB models in a large clinical treatment seeking sample ( N = 679), applying both DSM-IV and DSM-5 criteria for bulimic-type eating disorders. Application of the DSM-5 criteria reduced the number of cases of DSM-IV bulimic-type eating disorders not otherwise specified to 29.6 %. Structural equation modelling analysis indicated that (a) although both models provided a good fit to the data, the CB-E model accounted for a greater proportion of variance in eating-disordered behaviours than the original one, (b) interpersonal problems, clinical perfectionism and low self-esteem were indirectly associated with dietary restraint through over-evaluation of shape and weight, (c) interpersonal problems and mood intolerance were directly linked to binge eating, whereas restraint only indirectly affected binge eating through mood intolerance, suggesting that factors other than restraint may play a more critical role in the maintenance of binge eating. In terms of strength of the associations, differences across DSM-5 bulimic-type eating disorder diagnostic groups were not observed. The results are discussed with reference to theory and research, including neurobiological findings and recent hypotheses. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) is characterized by high rates of comorbid internalizing and externalizing disorders. One mechanistic account of these comorbidities is that ASD is characterized by impaired emotion regulation (ER) that results in deficits modulating emotional responses. We assessed neural activation during cognitive reappraisal of faces in high functioning adults with ASD. Groups did not differ in looking time, pupilometry, or subjective ratings of faces during reappraisal. However, instructions to increase positive and negative emotional responses resulted in less increase in nucleus accumbens and amygdala activations (respectively) in the ASD group, and both regulation instructions resulted in less change in dorsolateral prefrontal cortex activation in the ASD group. Results suggest a potential mechanistic account of impaired ER in ASD. [ABSTRACT FROM AUTHOR]

For the last half-century, many in the social work academy have questioned whether private practitioners have forsaken the mission and values of social work. This article suggests that for the experienced social worker, private practice is part of a natural developmental process that can be deeply congruent with the values of the profession. However, there continues to be relatively little support within the academy for private practice. The more important question today may be: Has the social work profession forsaken the private practitioner? [ABSTRACT FROM AUTHOR]

The pursuit of preferences without demands is a major pathway to mental health and happiness, according to REBT theory and research. Even when people are thwarted in the pursuit of their preferences, they will only experience healthy negative emotions, which will spur them on to construct solutions to obstacles that prevent them from reaching their goals. However, if they are thwarted when rigidly demanding their preferences, they may experience unhealthy negative emotions and act in ways that most likely will be self-defeating. We suggest that this evidence-based classic REBT framework could benefit further by clarifying whether there is a neglected distinction to be made between two types of preference. We raise the question whether there are 'ought' preferences as well as 'want' preferences, fundamentally different in purpose, which when turned into demands, can lead to distinctly different secondary irrational beliefs and unhealthy negative emotions and behaviour patterns. We explore this possible distinction as a question which has potential ramifications for theory, research and practice. [ABSTRACT FROM AUTHOR]

Background: Functional analytic psychotherapy (FAP) is a contextual behavior therapy that targets idiographic behaviors relevant to interpersonal functioning. FAP often targets issues with intimacy, defined as behavior exchanges that are vulnerable to interpersonal punishment. While existing measures examine similar constructs to FAP's conceptualization of intimacy, the literature lacks a FAP-consistent self-report measure that adequately captures intimacy-related behavior with the capacity to assess behavior change and aid in clinical outcome research. Method: The Functional Analytic Psychotherapy Intimacy Scale (FAPIS) is a 14-item measure developed for both clinicians and researchers to assess intimacy-related behavior. Utilizing two samples of undergraduate students, exploratory and confirmatory factor analyses were conducted, supporting factorial validity of the FAPIS. Results: Reliability tests, including internal consistency and test-retest reliability and construct validity were assessed, providing further support for the psychometric properties of the FAPIS. Conclusions: The FAPIS appears to be a psychometrically sound measure of intimacy that could assist in future FAP-related research. Further research should also assess the FAPIS for clinical utility. [ABSTRACT FROM AUTHOR]

The model of self-discrepancies (Higgins in Psychol Rev 94:319-340, ) serves as theoretical framework to investigate whether a perceived discrepancy between the external and self-image ('self-other') is uniquely relevant to paranoid symptoms. This is achieved by comparing the effect of 'self-other' and 'self-ideal' discrepancies on paranoid and depressive symptoms. It is also tested whether emotions such as anxiety and sadness mediate the proposed associations. Self-discrepancies ('self-other' and 'self-ideal') were experimentally induced in a repeated measures design with 60 healthy participants. Symptoms and emotions were compared between both self-discrepancy conditions as well as to a control condition. The findings confirmed the proposed effect of the discrepancy 'self-other' on paranoid symptoms and the mediating effect of anxiety. However, the discrepancy 'self-ideal' also lead to an increase in paranoid symptoms. The findings also confirmed the effect of the discrepancy 'self-ideal' on depressive symptoms and the mediating effect of sadness. It is concluded that the discrepancy 'self-ideal' is a specific vulnerability factor for depressive symptoms, which is mediated by sadness. In contrast, paranoid symptoms are not uniquely related to 'self-other' discrepancies but can be triggered by both types of self-discrepancies. [ABSTRACT FROM AUTHOR]

Anhedonia is characterized by a reduced capacity to experience pleasure in response to rewarding stimuli and has been considered a possible candidate endophenotype in depression and schizophrenia. However, it is still not well understood whether these reward deficits are confined to anticipatory and/or to consummatory experiences of pleasure. In the present study, we recorded electrophysiological responses (event-related brain potentials [ERPs] and oscillatory activity) to monetary gains and losses in extreme groups of anhedonic and nonanhedonic participants. The anhedonic participants showed reduced motivation to incur risky decisions, especially after monetary rewards. These sequential behavioral effects were correlated with an increased sensitivity to punishment, which psychometrically characterized the anhedonic group. In contrast, both electrophysiological measures associated with the impacts of monetary losses and gains-the feedback-related negativity (FRN) and the beta-gamma oscillatory component-clearly revealed preserved consummatory responses in anhedonic participants. However, anhedonics showed a drastic increase in frontal medial theta power after receiving the maximum monetary gain. This increase in theta oscillatory activity could be associated with an increase in conflict and cognitive control for unexpected large positive rewards, thus indexing the violation of default negative expectations built up across the task in anhedonic participants. Thus, the present results showed that participants with elevated scores on Chapman's Physical Anhedonia Scale were more sensitive to possible punishments, showed deficits in the correct integration of response outcomes in their actions, and evidenced deficits in sustaining positive expectations of future rewards. This overall pattern suggests an effect of anhedonia in the motivational aspects of approach behavior rather than in consummatory processes. [ABSTRACT FROM AUTHOR]

There are obvious similarities between the cognitive constructs of Beck's cognitive theory, the hopelessness model, and the response styles theory. No single comprehensive model has yet integrated the core cognitive concepts of these theories, however. In order to develop such an integrative cognitive model, we conducted two independent studies with 588 and 606 participants, respectively, from a university population. Both studies support the idea that all cognitive constructs of the three models are distinct from each other. Furthermore, both studies provide evidence for the possibility an integration of the constructs in one cognitive model. If future studies replicate these findings, the integrated cognitive model can provide a theoretical framework to better understand how therapeutic techniques derived from one model influence cognitive variables from another model. This might even allow for improvements in the effectiveness of psychotherapies by theory-driven combinations of therapeutic techniques that are based on different models. [ABSTRACT FROM AUTHOR]

Positive affective functioning (PAF) is critical to the development, course and treatment of depressive symptoms. Targeting key features of PAF during treatment may provide a new angle through which to improve affective functioning and reduce symptoms. The current study was a treatment development trial for the Positive Affect Stimulation and Sustainment (PASS) Module. PASS is conceptualized as a means of capitalizing on positive events (e.g., planned through behavioral activation) by enhancing and sustaining positive affective states through savoring, and establishing positive attributions and expectancies. Participants were 27 female college students with dysphoric symptoms. There was a moderate effect of PASS on depressive symptoms. There was also a significant within session increase in positive affect from pre to post session among the PASS group, relative to active control; and a significant decrease in positive affect from pre (baseline) to post (follow-up) treatment among the control group, relative to PASS. Results provide preliminary evidence for the efficacy of the treatment module among young adults with depressed mood, and lay the foundation for future research. [ABSTRACT FROM AUTHOR]

The association between child sexual abuse (CSA) and feminine gender-role identity was examined among 75 women with and 107 without a history of CSA. Undergraduates and hospital employees from a university in the Southern United States completed questionnaires on the internet. Three aspects of feminine identity were assessed, including how much participants identified with feminine versus masculine traits, endorsed stereotypes about women, and viewed themselves as meeting feminine self-standards. Participants with a history of CSA reported greater feminine self-discrepancy and endorsed more derogatory stereotypes about women than the comparison group. CSA was also linked to identifying with more feminine than masculine traits, but only among hospital employees. Results suggest that feminine identity is a meaningful construct to consider in the adjustment of CSA survivors. [ABSTRACT FROM AUTHOR]

This study evaluated the short-term impact of YWCA Encore, a mixed-modality group exercise and information support program for breast cancer patients situated in the community setting. Australian post-surgical breast cancer patients ( N = 162) were assigned to either the 8-week Encore intervention or a Waitlist control. Intervention impact was assessed in terms of quality of life, cancer-specific distress, and social support. Changes in familiarity with exercise, self-efficacy and social support were tested as mediators of the intervention impact on quality of life. Overall adherence and satisfaction with the program were high. Significant enhancements at follow-up for quality of life and social support were evident for intervention compared with control participants. Familiarity with exercise and self-efficacy satisfied the requirements for mediation of quality of life. These findings provide evidence for psychosocial benefits of YWCA Encore multi-component program and support the use of such community-based programs for breast cancer survivors. The role of exercise familiarity and self-efficacy as probable mediators of the multi-component intervention is a critical finding and highlights the need for future investigations into the underlying mediating processes of similar interventions for cancer patients. [ABSTRACT FROM AUTHOR]

The author introduces the special section on mindfulness: four articles that between them explore the correlates of mindfulness in both cross-sectional and treatment studies. Results from these studies, taken together, suggest a close association between higher levels of mindfulness, either as a trait or as cultivated during treatment, and lower levels of rumination, avoidance, perfectionism and maladaptive self-guides. These four characteristics can be seen as different aspects of the same ‘mode of mind’, which prioritizes the resolution of discrepancies between ideas of current and desired states using a test-operate-test-exit sequence. Mindfulness training allows people to recognize when this mode of mind is operating, to disengage from it if they choose, and to enter an alternative mode of mind characterized by prioritizing intentional and direct perception of moment-by-moment experience, in which thoughts are seen as mental events, and judgemental striving for goals is seen, accepted and ‘let go’. [ABSTRACT FROM AUTHOR]

Long-term vulnerability to depression is related to the presence of perceived discrepancies between the actual self and ideal self-guides. This study examined the immediate effects of an 8-week course of Mindfulness-Based Cognitive Therapy (MBCT) on self-discrepancies in individuals currently in recovery, with a history of affective disorder that included suicidal ideation and behaviour. Results indicated significant time × group interactions for both ideal self similarity and ideal self likelihood ratings, primarily accounted for by increases in self-discrepancy from pre-test to post-test in the waiting list group which were not seen in those receiving MBCT. Changes in self-discrepancy were not associated with changes in residual depressive symptoms, but in the MBCT group there was a significant association between increases in ideal self similarity and the adoption of more adaptive ideal self-guides post treatment. MBCT may protect against increases in self-discrepancy in people vulnerable to relapse to depression and may also facilitate a shift in the goals of self-regulation. [ABSTRACT FROM AUTHOR]

Abstract Background  Progressive resistance training (PRT) may be effective for targeting the sequelae of breast cancer and its treatment given the unique anabolic nature of this exercise modality. Therefore, our objectives were: (1) to systematically review studies that have prescribed PRT after breast cancer surgery, (2) to summarize the efficacy of PRT in this cohort, and (3) to delineate areas for future investigations. Method  A systematic review using computerized databases was performed. Results  The systematic review located 10 trials: Four uncontrolled trials, one controlled trial and five randomized controlled trials (RCTs). PRT was prescribed with aerobic training in 8/10 trials reviewed, and in isolation in 2/10 trials reviewed. Upper body PRT was prescribed in 7/10 trials, including 4/5 RCTs. No exacerbation of objectively measured or subjectively reported lymphedema symptoms was reported in any of these trials. Adverse events were rare, generally musculoskeletal in nature, and were managed effectively by conservative means. Overall, the studies we reviewed suggest that women surgically treated for breast cancer can derive health-related and clinical benefits by performing PRT after breast cancer surgery. Further research may be required to stimulate greater advocacy for PRT among oncologists, and in community care settings. Conclusions  Robustly designed RCTs prescribing targeted PRT regimens throughout various phases of breast cancer treatment are warranted. RCTs with thorough, standardized reporting of interventions and adverse events are required to establish the efficacy of this intervention for the post-treatment management of breast cancer patients and survivors as a means to improve health status and quality of life. [ABSTRACT FROM AUTHOR]

The promise of a new generation of therapies targeted to address neurobiological mechanisms thought to underlie psychological disorders, particularly depression, using cognitive and behavioral techniques is discussed. Relationships between such neurobehaviorally focused therapies and other psychological and rehabilitative interventions are also discussed. Their potential utility as adjuncts to conventional treatment, and the importance of multi-method assessment in their evaluation are emphasized. Finally, initial data from a neurobehavioral “cognitive control training” (CCT) adjunctive intervention for severe unipolar depression is presented as an extended example. These data suggest that CCT aids in reducing both physiological mechanisms underlying depression as well as depressive symptomatology. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the exercise beliefs of breast cancer survivors before and after participation in a randomized trial. Prior to randomization, 52 breast cancer survivors completed exercise belief measures based on the theory of planned behavior. After the trial, participants assigned to the exercise group (n = 24) completed the belief measures again. Results show that there was significant variability in the expected benefits of exercise prerandomization, ranging from 40% for a reduced risk of breast cancer recurrence to 94% for an improved energy level. Moreover, attitudes toward exercise and perceptions of control were higher in the exercise group after the exercise program. The findings are discussed in terms of the veracity of the exercise beliefs held by breast cancer survivors as well as the aspects of the program that may have contributed to the positive changes in exercise beliefs. [ABSTRACT FROM AUTHOR]

The purpose of this study was to examine the exercise beliefs of breast cancer survivors before and after participation in a randomized trial. Prior to randomization, 52 breast cancer survivors completed exercise belief measures based on the theory of planned behavior. After the trial, participants assigned to the exercise group (n = 24) completed the belief measures again. Results show that there was significant variability in the expected benefits of exercise prerandomization, ranging from 40% for a reduced risk of breast cancer recurrence to 94% for an improved energy level. Moreover, attitudes toward exercise and perceptions of control were higher in the exercise group after the exercise program. The findings are discussed in terms of the veracity of the exercise beliefs held by breast cancer survivors as well as the aspects of the program that may have contributed to the positive changes in exercise beliefs. [ABSTRACT FROM AUTHOR]

Despite numerous studies of approach- and avoidant mindsets, relatively little research has addressed the impact of such motivational orientations on performance and emotion in a real-time, multi-task setting. A laboratory simulation is reported that examines the influence of an induced approach-centered, an avoidance-centered, and a “neutral” motivational mindset upon multiple aspects of task performance, self-regulatory cognition, and affect. Undergraduate females randomly assigned to one of three mindset conditions performed a simulated automobile drive across one practice and two experimental trials. Dependent measures included divided attention, behavioral indicators of driving “cautiousness” in relatively safe straight roadway sections as well as during more risk-filled driving, multiple aspects of self-regulatory thinking (including self-monitoring, intended effort, and self-administered consequences), and positive and negative affect. Results revealed that the avoidant mindset produced poorer executive attention (i.e., fewer correctly detected divided attention events), more “cautious” driving behavior and reduced performance variability (i.e., greater control) when driving on presumably safe, straight roadway sections, lower self-reports of intended effort, and greater negative affect relative to the approach mindset. Results are intepreted within a self-regulation-centered motivational framework. Implications of the multi-task simulation for the study of normal and disordered adjustment are considered. [ABSTRACT FROM AUTHOR]

Self-discrepancy theory [E. T. Higgins, 1987] proposes that discrepancies between self and ‘ideal’ standards are associated with dejection-related emotions, whereas discrepancies between self and ‘ought’ standards are associated with agitation-related emotions. Although there is substantial evidence to support the ideal/ought distinction, the traditional method used to measure self-discrepancies contains some theoretical and conceptual limitations. This paper discusses these limitations, presents a critique of other methods of measuring self-discrepancies and suggests a new measurement technique, the Self-Lines measure. This new approach is consistent with the theoretical underpinning of self-discrepancy theory. A pilot study suggests that this approach is feasible and two comparative studies demonstrate the validity and advantages of the Self-Lines measure. [ABSTRACT FROM AUTHOR]

Abstract The benefit of exercise for cancer patients is starting to become recognized. The purposes of this paper were to review the literature to examine whether research findings are being converted into guidelines for patients and survivors and to examine the quality of evidence on which they were based. A computer search of major health databases was conducted for peer-reviewed literature and books on exercise and cancer, and an Internet search was conducted for cancer websites reporting any exercise guidelines/recommendations for cancer patients. Seven peer-reviewed articles, eight books and eight cancer websites were identified that suggested exercise guidelines for cancer patients and survivors. None of the published guidelines identified appeared to have been developed via a process that would allow them to be cited as evidence-based guidelines. Based on the studies to date, no direct cancer-specific evidence about the best type, frequency, duration or intensity of exercise is currently available in the peer-reviewed literature. It is currently not known what would be most beneficial for which cancers, at which stage of disease or treatment. Given the current interest in cancer and exercise, there is an urgent need for an evidence-based set of exercise guidelines to be developed. [ABSTRACT FROM AUTHOR]

Abstract Expectations and experiences of the interpersonal behaviour between the counselor and the client were investigated in an exploratory study, and related to the evaluation of career counseling sessions with adolescents in a secondary school context in Sweden. The relationship was measured by using the Structural Analysis of Social Behaviour model (SASB). In general, positive evaluation as judged by the clients was found to be related to the clients having more positive expectations and experience of their own and counselors affiliative behaviour. No positive associations between own expected and experienced behaviour and evaluation were found as judged by the counselors. Affiliative behaviour was found to be the most important dimension in predicting evaluation of sessions in a positive way for the clients. [ABSTRACT FROM AUTHOR]

Objective: To systematically review controlled trials investigating the effects of exercise interventions in cancer patients. [ABSTRACT FROM AUTHOR]

To date, few studies have been published on the dose–response relationship in psychotherapy. The current study addresses limitations of previous research by using (1) clinical significance methodology to address the meaningfulness of patient change, (2) survival analysis to assess change across time, (3) assessment of patient change on a session-by-session basis, and (4) a large data set representing a variety of treatment settings. A total of 4,761 patients representing standard treatment settings in the United States were tracked at each session of therapy. A survival analysis of this data reveals that between 15 and 19 sessions of therapy are required for a 50% recovery rate using clinical significance methodology. The results of this study provide a useful overview of time-to-change in naturalistic settings that can be used to estimate reliable treatment expectations and as a baseline for comparison when modifications are made within treatment delivery systems. [ABSTRACT FROM AUTHOR]