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Mindfulness-based cognitive therapy (MBCT) and mindfulness-based stress reduction (MBSR) are particularly effective treatment approaches in terms of alleviating depressive symptoms and preventing relapse once remission has been achieved. Although engaging in mindfulness practice is an essential element of both treatments; it is unclear whether informal or formal practices differentially impact on symptom alleviation. The current study utilizes a correlational design to examine data provided by thirty-two previously depressed, remitted outpatients who received either MBCT or MBSR treatment. Outpatients in the MBCT group received treatment as part of a previously published randomized efficacy trial (Segal et al. in Arch Gen Psychiatry 67:1256–1264, 2010), while those in the MBSR group received treatment as part of a separate, unpublished randomized clinical trial. Throughout treatment, clients reported on their use of formal and informal mindfulness practices. Results indicate that engaging in formal (but not informal) mindfulness practice was associated with decreased rumination, which was associated with symptom alleviation.

Historically, research on metacognition originated in child psychologists' analyses of changes in reasoning abilities associated with cognitive development and maturation. In its broadest sense, this construct was understood as the ability to think about one's thinking in the context of problem solving and social processing. More recently, these concepts have become figural in theoretical accounts of clinical syndromes and as possible mediators of the effectiveness of cognitive treatments, specifically by teaching patients a way to observe and reappraise distressing thoughts and feelings. In this article, the authors review the current state of metacognitive theory as it relates to depressive and anxiety-based disorders and evaluate the extant evidence base for these models.

Sprengelmeyer et al. [Sprengelmeyer, R., Young, A. W., Pundt, I., Sprengelmeyer, A., Calder, A. J., Berrios, G., et al. (1997). Disgust implicated in obsessive-compulsive disorder. Proceedings of the Royal Society of London, 264, 1767-1773] found that patients with OCD showed severely impaired recognition of facial expressions of disgust. This result has potential to provide a unique window into the psychopathology of OCD, but several published attempts to replicate this finding have failed. The current study compared OCD patients to normal controls and panic disorder patients on ability to recognize facial expressions of negative emotions. Overall, the OCD patients were impaired in their ability to recognize disgust expressions, but only 33% of patients showed this deficit. These deficits were related to OCD symptom severity and general functioning, factors that may account for the inconsistent findings observed in different laboratories.

Cognitive theories of obsessive-compulsive disorder (OCD) posit that appraisals about the significance of thoughts are critical in the development and persistence of obsessions. Rachman [(1997). A cognitive theory of obsessions. Behaviour Research and Therapy, 35, 793-802.] proposes that appraisals of unwanted thoughts distinguish clinical obsessions from normal intrusive thoughts; thoughts appraised as important and personally significant are expected to be upsetting and recur. Appraisals are also expected to be related to symptoms of OCD. To explore the features of normal appraisals of obsession-like thoughts, nonclinical participants in two studies rated the personal significance of intrusive thoughts portrayed in vignettes containing prototypical themes associated with primary obsessions: aggressive, sexual, and blasphemous thoughts. Unwanted intrusive thoughts that were described as occurring more frequently were appraised as more personally significant, but participants appraised these socially unacceptable thoughts similarly whether they imagined having personally experienced them or a friend confiding about having experienced them. Appraisals in both studies were related to subclinical OC symptoms and OC beliefs.

Exposure with response prevention and cognitive behavior therapy are widely recognized as effective treatments for obsessive-compulsive disorder. Unfortunately, many people with obsessive-compulsive disorder--particularly those living in rural areas--do not have access to therapists providing these treatments. Accordingly, we investigated the efficacy of telephone-administered cognitive behavior therapy for obsessive-compulsive disorder. Two open trials are reported, for a total of 33 people with obsessive-compulsive disorder (without major depression). The first trial consisted of 12 weeks on a waiting list followed by 12 weeks of treatment (delayed treatment). The second trial consisted of 12 weeks of immediate treatment. Obsessive-compulsive symptoms did not change during the waiting period. Symptoms declined from pre- to post-treatment, with gains maintained at 12-week follow-up. For the pooled sample our pre-to-post-treatment effect size was as large or larger than those obtained in other studies of reduced contact treatment, and similar to those of face-to-face exposure with response prevention. Our proportion of treatment dropouts tended to be lower than those of other reduced contact interventions. The results suggest that telephone-administered cognitive behavior therapy is effective and well-tolerated, at least for people with obsessive-compulsive disorder without major depression. It remains to be seen whether this treatment is safe and effective when comorbid major depression is present.

What do novice word learners know about the sound of words? Word-learning tasks suggest that young infants (14 months old) confuse similar-sounding words, whereas mispronunciation detection tasks suggest that slightly older infants (18-24 months old) correctly distinguish similar words. Here we explore whether the difficulty at 14 months stems from infants' novice status as word learners or whether it is inherent in the task demands of learning new words. Results from 3 experiments support a developmental explanation. In Experiment 1, infants of 20 months learned to pair 2 phonetically similar words to 2 different objects under precisely the same conditions that infants of 14 months (Experiment 2) failed. In Experiment 3, infants of 17 months showed intermediate, but still successful, performance in the task. Vocabulary size predicted word-learning performance, but only in the younger, less experienced word learners. The implications of these results for theories of word learning and lexical representatio...

This chapter reviews epidemiology, diagnostic criteria, societal burden, treatment efficacy, and clinical recommendations for two forms of chronic depression, specifically, dysthymic disorder and chronic major depression. Comparisons of individuals with different presentations of chronic depression have revealed few differences in demographic, clinical, and familial characteristics, or in treatment response. However, comparisons of nonchronic versus chronically depressed samples indicate substantial differences with higher levels of comorbidity, prevalence of child adversity, parental psychopathology, and societal burden among those with chronic forms of depression. The chapter reviews findings on treatments for chronic major depression and dysthymic disorder, including cognitive behavioral therapy, interpersonal therapy, cognitive behavioral analysis system of psychotherapy, pharmacotherapy, and combined treatment. It is argued that the length of treatment trials to date lacks empirical basis and does not reflect the long-term nature of the illness. Treatment recommendations specific to chronic forms of depression are discussed. Keywords: epidemiology of chronic depression; economic burden; cognitive behavior therapy; CBT; interpersonal therapy; IPT; cognitive behavioral analysis system of psychotherapy; CBASP; combined treatment

To examine whether metacognitive psychological skills, acquired in mindfulness-based cognitive therapy (MBCT), are also present in patients receiving medication treatments for prevention of depressive relapse and whether these skills mediate MBCT's effectiveness.This study, embedded within a randomized efficacy trial of MBCT, was the first to examine changes in mindfulness and decentering during 6-8 months of antidepressant treatment and then during an 18-month maintenance phase in which patients discontinued medication and received MBCT, continued on antidepressants, or were switched to a placebo. In total, 84 patients (mean age = 44 years, 58% female) were randomized to 1 of these 3 prevention conditions. In addition to symptom variables, changes in mindfulness, rumination, and decentering were assessed during the phases of the study.Pharmacological treatment of acute depression was associated with reductions in scores for rumination and increased wider experiences. During the maintenance phase, only patients receiving MBCT showed significant increases in the ability to monitor and observe thoughts and feelings as measured by the Wider Experiences (p.01) and Decentering (p.01) subscales of the Experiences Questionnaire and by the Toronto Mindfulness Scale. In addition, changes in Wider Experiences (p.05) and Curiosity (p.01) predicted lower Hamilton Rating Scale for Depression scores at 6-month follow-up.An increased capacity for decentering and curiosity may be fostered during MBCT and may underlie its effectiveness. With practice, patients can learn to counter habitual avoidance tendencies and to regulate dysphoric affect in ways that support recovery.

Cognitive theories of obsessions highlight appraisals of personal significance and thought suppression in the development and maintenance of intrusive thoughts. The current study examined the role of personal significance within the context of a thought suppression paradigm. The primary aim was to examine whether suppression would have differential effects for target thoughts appraised as personally meaningful versus relatively unimportant. A blasphemous thought served as the target thought, and highly religious and nonreligious participants were recruited. Participants completed a two-interval thought suppression task; during interval 1 they were randomly assigned to suppress or not suppress the target thought and during interval 2, all participants were given "do not suppress" instructions. Suppression resulted in sustained frequency of thoughts in contrast to the decline in thought frequency observed for non-suppression. Differential effects of suppression were found across the two groups. Moreover, suppression was associated with increased negative mood and anxiety. Results suggest that suppression of personally meaningful thoughts is a counterproductive strategy.

Cognitive behaviour therapy is effective for obsessive-compulsive disorder and for obsessive-compulsive spectrum disorders such as trichotillomania. Unfortunately, many people with these disorders, especially those living in rural areas, have limited access to treatment. Telephone-administered cognitive behaviour therapy may help address this problem. In a recent study of telephone treatment for obsessive-compulsive disorder, we found that such treatment was often effective (42% in remission at post-treatment, and 47% in remission at 12-week follow-up). This article presents 2 case reports of the same treatment, applied to obsessive-compulsive spectrum disorders (trichotillomania and compulsive skin picking). Treatment was associated with symptom reduction for both participants, although one subsequently relapsed. Possible reasons for relapse are discussed. The findings encourage further studies to identify the characteristics of people most likely to benefit from telephone treatment for spectrum disorders.

The MHC class I antigen presentation pathway is a frequent target of virus-encoded immune evasion molecules. Proteins of the viral K3 family are E3 ubiquitin ligases that downregulate immune modulatory molecules. Further, it has been established that the K3 family has cellular homologs (Membrane-Associated RING-CH proteins), some of which act to regulate immune molecules via ubiquitination. The mK3 molecule of γ-herpesvirus 68 has been shown to utilize ER-associated degradation pathways to degrade MHC class I, thereby inhibiting antigen presentation. Here, we have explored the basis for specific targeting of class I for ubiquitination by mK3. We provide direct evidence that adapter proteins (TAP/tapasin, in this case) in the ER membrane position the RING-CH domain of mK3 to permit ubiquitination of the cytosolic tail of the class I heavy-chain. This was accomplished by generating a novel substrate for mK3 which could be ubiquitinated only when placed within the proper orientation within the TAP complex. These findings demonstrate an essential role of adapter proteins in ubiquitin ligase substrate selection, with implications for substrate selection by other K3-related E3 ligases within the immune system.