Olfactory mucosa of the South American armadillo Chaetophractus villosus: an ultrastructural study

OBJECTIVE: Morbidly obese individuals are unlikely to reach and maintain normative weights. Thus, interventions aimed at alleviating corollary problems, independent of attempts at weight loss, are appropriate. A cognitive group treatment program (CT) was developed which incorporated a nondieting approach, regular exercise, and use of alternative coping skills. Weight loss per se was not a focus of the intervention. The purpose of the current work was to evaluate this program in a controlled, comparative treatment outcome study. METHOD: Sixty-two obese women with a history of treatment failures were randomly assigned to the CT program, a behavior therapy weight loss program (BT), or a wait-list control group. RESULTS: For CT participants, depression, anxiety, and eating-related psychopathology decreased significantly over the course of treatment while perceptions of self-control increased; BT and control subjects showed no significant changes in these variables. Women in both active treatment groups lost significant amounts of weight, while members of the control group showed a nonsignificant increase in weight. At 6-month follow-up, treatment benefits were maintained. DISCUSSION: Findings suggest that interventions not directly aimed at weight loss can enhance psychological well-being and thus may be appropriate for some obese women.     

Interpersonal attachment cognitions and prediction of symptomatic responses to interpersonal stress.

The authors tested a cognitive-interpersonal hypothesis of depression by examining the role of interpersonal cognitions in the prediction of depression associated with interpersonal stressors. A measure of adult attachment assessed interpersonal cognitions about ability to be close to others and to depend on others and anxiety about rejection and abandonment. Participants were women who had recently graduated from high school; they were followed for 1 year with extensive interview evaluation of life events, depression, and other symptomatology. Generally, cognitions, interpersonal events, and their interactions contributed to the prediction of interview-assessed depressive symptoms, but the effects were not specific to depression and predicted general symptomatology measured by diagnostic interviews as well, and results also varied by attachment subscale. Results were discussed in terms of a developmental psychopathology approach to disorders in young women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changes in self-schema structure in cognitive therapy for major depressive disorder: A randomized clinical trial.

Negative cognitive structure (particularly for interpersonal content) has been shown in some research to persist past a current episode of depression and potentially to be a stable marker of vulnerability for depression (D. J. A. Dozois, 2007; D. J. A. Dozois & K. S. Dobson, 2001a). Given that cognitive therapy (CT) is highly effective for treating the acute phase of a depressive episode and that this treatment also reduces the risk of relapse and recurrence, it is possible that CT may alter these stable cognitive structures. In the current study, patients were randomly assigned to CT+ pharmacotherapy (n = 21) or to pharmacotherapy alone (n = 21). Both groups evidenced significant and similar reductions in level of depression (as measured with the Beck Depression Inventory–II and the Hamilton Rating Scale for Depression), as well as automatic thoughts and dysfunctional attitudes. However, group differences were found on cognitive organization in favor of individuals who received the combination of CT+ pharmacotherapy. The implications of these results for understanding mechanisms of change in therapy and the prophylactic nature of CT are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain injury in battered women.

The goals of the present study were to examine (a) whether battered women in a sample of both shelter and nonshelter women are sustaining brain injuries from their partners, and (b) if so, whether such brain injuries are associated with partner abuse severity, cognitive functioning, or psychopathology. Ninety nine battered women were assessed using neuropsychological, psychopathology, and abuse history measures. Almost three quarters of the sample sustained at least 1 partner-related brain injury and half sustained multiple partner-related brain injuries. Further, in a subset of women (n = 57), brain injury severity was negatively associated with measures of memory, learning, and cognitive flexibility and was positively associated with partner abuse severity, general distress, anhedonic depression, worry, anxious arousal, and posttraumatic stress disorder symptomatology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative Cognitive Therapy for Depression: A Preliminary Investigation.

This study is a preliminary investigation of an integrative treatment aimed at improving the efficacy of cognitive therapy (CT) for depression. The development of the treatment protocol was based on process findings, which suggested that strategies used in CT to resolve alliance ruptures may actually exacerbate problems in the therapeutic relationship. The protocol integrates, within the traditional CT treatment manual, procedures to repair alliance ruptures that are derived from or consistent with humanistic and interpersonal therapies. Although conducted by inexperienced therapists, the integrative treatment led to greater improvement than a waiting-list condition. The results also compare favorably to previous findings for CT. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Preventing Relapse/Recurrence in Recurrent Depression With Cognitive Therapy: A Randomized Controlled Trial.

This article reports on the outcome of a randomized controlled trial of cognitive group therapy (CT) to prevent relapse/recurrence in a group of high-risk patients diagnosed with recurrent depression. Recurrently depressed patients (N = 187) currently in remission following various types of treatment were randomized to treatment as usual, including continuation of pharmacotherapy, or to treatment as usual augmented with brief CT. Relapse/recurrence to major depression was assessed over 2 years. Augmenting treatment as usual with CT resulted in a significant protective effect, which intensified with the number of previous depressive episodes experienced. For patients with 5 or more previous episodes (41% of the sample), CT reduced relapse/recurrence from 72% to 46%. Our findings extend the accumulating evidence that cognitive interventions following remission can be useful in preventing relapse/recurrence in patients with recurrent depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrative cognitive therapy for depression: A randomized pilot comparison.

This pilot study examined the efficacy of an integrative form of cognitive therapy (ICT) for depression that incorporates specific strategies for addressing alliance ruptures. Although a previous study on depression found that ICT was superior to a wait-list condition (L. G. Castonguay et al., 2004), the current study provides the 1st direct comparison between ICT and traditional cognitive therapy (CT). Twenty-two depressed adults were randomly assigned to ICT or CT (11 patients per condition), which were delivered by clinicians in training. Outcome was assessed with a specific depression measure and a global symptomatology measure. The groups were also compared on patient-perceived alliance quality and therapist empathy. Effect size estimates revealed that ICT patients evidenced greater posttreatment improvement on both outcome measures (with small to medium effects) and more clinically significant change than did CT patients. ICT patients also had higher alliance and empathy scores across treatment (with medium to large effects). The findings, albeit very preliminary, support the potential viability of ICT and the potential causal influence of the rupture-repair interventions on treatment process and outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Toward a cognitive therapy for suicidal individuals.

Explores whether studies of cognitive characteristics of the suicidal individual differentiated the suicidal patient from other patients sufficiently enough to warrant a distinct treatment strategy. The cognitive characteristics of suicidal patients are reviewed, and it is argued that a wide assortment of studies has consistently revealed cognitive differences between suicidal and nonsuicidal individuals that are not attributable to depth of depression or degree of psychopathology. Some of the specific observed tendencies of suicidal patients are discussed, including cognitive rigidity, dichotomous thinking, ineffective problem solving, a view of suicide as a desirable solution, hopelessness, and cognitive distortions. Possible interventions for use with suicidal patients are suggested. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The use and nature of present-focused interventions in cognitive and behavioral therapies for depression.

To improve cognitive and behavioral therapies (CBT) for depression, several approaches recommend an increased focus on the occurrence of problems as they occur in the therapeutic relationship or in relation to the live therapy process, referred to as present-focused. A lingering question has been the degree to which CBT therapists already engage in present-focused work. This study utilized sessions from recent trials of CBT for depression and, in Phase I, raters identified present-focused interventions on a turn-by-turn basis. Phase II raters used a qualitative analysis to determine categories of present-focused interventions. Results indicated that therapists rarely focused on the therapeutic relationship; when they did, it was often transient and lacking in the elaborations suggested by newer approaches. Therapists more often performed therapy process and emotion focused interventions, but these also tended to lack elaboration. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effectiveness of cognitive therapy for depression in a community mental health center: A benchmarking study.

The current study examined the feasibility and effectiveness of transporting an empirically supported treatment for depression, cognitive therapy (CT), to a community mental health center setting. CT was delivered to 192 adult outpatients with major depression, and a benchmarking strategy compared results with those of 2 randomized controlled trials (RCTs). The 3 samples were largely similar in terms of initial severity of depression, and CT was as effective in reducing depressive symptoms in the current sample as in the RCTs. More favorable outcome was associated with less severe initial depression, more therapy sessions, more years of education, and absence of a comorbid personality disorder. This study demonstrates that an empirically supported treatment can be transported effectively to a clinical setting. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapist interventions and client emotional experiencing in expert psychodynamic–interpersonal and cognitive–behavioral therapies.

Eighteen sessions of cognitive–behavioral (CB) and 13 sessions of psychodynamic–interpersonal therapy obtained from experienced clinicians in a naturalistic setting were investigated to determine the various therapeutic interventions associated with high and low emotional experiencing (EXP). Clients receiving reflections and acknowledgments, affiliative and noncontrolling interventions, or interventions highlighting nonspecific client content were associated with maintained high EXP. Lengthier interventions and interventions rated as affiliative but moderately controlling were associated with shifts to low EXP. For clients of CB therapists, questions, interventions rated affiliative but controlling, and highlighting minimal emotional content were also associated with shifts to low EXP. Male therapists were associated with clients who maintained high EXP and female therapists were associated with clients who shifted to low EXP. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mental representations in personality development, psychopathology, and the therapeutic process.

This article considers the construct of mental representation from the perspectives of psychoanalytic object-relations theory and cognitive developmental psychology and the congruence of these formulations with research and theory in cognitive science and social cognition. Concepts of mental representation are applied to the study of psychopathology, personality assessment, interpersonal relationships or attachment styles, and therapeutic progress in the long-term, inpatient treatment of seriously disturbed adolescents and young adults. Understanding of personality development, psychopathology, and the therapeutic process is greatly enhanced by this constructivist perspective, which considers the construction of mental representations or cognitive–affective schemes to be a central constituent of personality development and organization. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

How does sexual minority stigma “get under the skin”? A psychological mediation framework.

Sexual minorities are at increased risk for multiple mental health burdens compared with heterosexuals. The field has identified 2 distinct determinants of this risk, including group-specific minority stressors and general psychological processes that are common across sexual orientations. The goal of the present article is to develop a theoretical framework that integrates the important insights from these literatures. The framework postulates that (a) sexual minorities confront increased stress exposure resulting from stigma; (b) this stigma-related stress creates elevations in general emotion dysregulation, social/interpersonal problems, and cognitive processes conferring risk for psychopathology; and (c) these processes in turn mediate the relationship between stigma-related stress and psychopathology. It is argued that this framework can, theoretically, illuminate how stigma adversely affects mental health and, practically, inform clinical interventions. Evidence for the predictive validity of this framework is reviewed, with particular attention paid to illustrative examples from research on depression, anxiety, and alcohol-use disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Facial affect processing and depression susceptibility: Cognitive biases and cognitive neuroscience.

Facial affect processing is essential to social development and functioning and is particularly relevant to models of depression. Although cognitive and interpersonal theories have long described different pathways to depression, cognitive-interpersonal and evolutionary social risk models of depression focus on the interrelation of interpersonal experience, cognition, and social behavior. We therefore review the burgeoning depressive facial affect processing literature and examine its potential for integrating disciplines, theories, and research. In particular, we evaluate studies in which information processing or cognitive neuroscience paradigms were used to assess facial affect processing in depressed and depression-susceptible populations. Most studies have assessed and supported cognitive models. This research suggests that depressed and depression-vulnerable groups show abnormal facial affect interpretation, attention, and memory, although findings vary based on depression severity, comorbid anxiety, or length of time faces are viewed. Facial affect processing biases appear to correspond with distinct neural activity patterns and increased depressive emotion and thought. Biases typically emerge in depressed moods but are occasionally found in the absence of such moods. Indirect evidence suggests that childhood neglect might cultivate abnormal facial affect processing, which can impede social functioning in ways consistent with cognitive-interpersonal and interpersonal models. However, reviewed studies provide mixed support for the social risk model prediction that depressive states prompt cognitive hypervigilance to social threat information. We recommend prospective interdisciplinary research examining whether facial affect processing abnormalities promote—or are promoted by—depressogenic attachment experiences, negative thinking, and social dysfunction. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Mediators and moderators of change in cognitive therapy of depression.

Reviews the theoretical and empirical literature associated with the mediators and moderators of change in cognitive therapy (CT) of depression. Covariation between change in cognition and change in depression, specific effects for cognitive vs behavioral components of CT, specific effects for CT vs other treatments, moderating influence of nonspecific and technical aspects of the therapeutic environment, and moderating influence of client characteristics are reviewed. The clinical implications of prior research and suggestions for future research on identifying the critical ingredients of change in CT of depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental psychopathology in infancy: Illustration from the study of maltreated youngsters.

Infancy is a period of rapid developmental change, characterized by transitions and qualitative reorganizations within and among biological, social, emotional, cognitive, and linguistic systems. Consequently, it is argued that it is inappropriate to focus on discrete symptomatology to infer the presence of nascent or incipient infant psychopathology. Rather, disorders in infancy are best conceptualized as relational psychopathologies, that is, as consequences of dysfunction in the parent–child-environment system. Research in the area of child maltreatment is used to illustrate the developmental psychopathology perspective as it applies to relational disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment acceptability of alternative therapies for depression: A comparative analysis.

174 college students were presented with the case scenarios of a 19-yr-old college student with either major depression or dysthymia. The treatment used in these case scenarios was described as consisting of behavioral, cognitive, interpersonal, or pharmacotherapy techniques. Ss were then administered a treatment evaluation inventory, the Semantic Differential, and a credibility rating scale to determine which treatment they thought was most acceptable. Interpersonal therapy was repeatedly rated as the most acceptable, followed by behavioral therapy, cognitive therapy, and pharmacotherapy. Ss viewed behavioral and cognitive approaches as equally acceptable across measures, but pharmacotherapy was consistently rated as least acceptable. Ss with evidence of depressive symptoms consistently rated psychotherapies as more acceptable than pharmacotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital adjustment and outcome following treatments for depression.

Marital adjustment and treatment outcome were evaluated in the Treatment of Depression Collaborative Research Program, a multicenter clinical trial evaluating interpersonal psychotherapy, cognitive therapy, imipramine, and placebo. Marital adjustment and depression were assessed pre- and posttreatment, and depression was assessed at 6, 12, and 18 months after treatment. Results indicate that (1) there was a significant improvement in marital adjustment after treatment, (2) this effect was not moderated by treatment type, and (3) this effect was mediated by change in depression. Poor pretreatment marital adjustment was modestly associated with negative outcome, whereas poor posttreatment marital adjustment was strongly associated with negative outcome during follow-up. The findings suggest that poor marital adjustment at the end of active treatment is a risk factor for increases in depression severity during follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)