Perfectionism has been conceptualized as a personality variable that underlies a variety of psychological difficulties. Recently, however, theorists and researchers have begun to distinguish between ...two distinct types of perfectionism, one a maladaptive form that results in emotional distress, and a second form that is relatively benign, perhaps even adaptive. In this study, we compared varying models of the perfectionism construct using the best known measures of perfectionism. In a sample of 198 students, three competing models of perfectionism were examined using confirmatory factor analysis. A model that incorporated two factors, one corresponding to maladaptive perfectionism and the other adaptive perfectionism, was a better fit to the data than a unitary perfectionism model. We also examined the relations of the two types of perfectionism, Maladaptive Evaluative Concerns and Positive Striving, to a well known measure of psychological distress. Maladaptive Evaluative Concerns was more strongly associated with depression, anxiety, stress, and test taking anxiety. Overall, this study supports the validity of a distinction between two types of perfectionism, and points to the importance of this duality for measurement and research on perfectionism.
Objective: 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. Method: 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. Results: 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. Conclusions: 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.
Objective:
Neuroimaging investigations reveal changes in glucose metabolism (fluorine-18-fluorodeoxyglucose positron emission tomography PET) associated with response to disparate antidepressant ...treatment modalities, including cognitive behavior therapy (CBT), antidepressant pharmacotherapies, and deep brain stimulation. Using a nonrandomized design, the authors previously compared changes following CBT or paroxetine in depressed patients. In this study, the authors report changes in fluorine-18-fluorodeoxyglucose PET in responders to CBT or venlafaxine during a randomized controlled trial.
Methods
Subjects meeting DSM-IV-TR criteria for a major depressive episode and a diagnosis of a major depressive disorder received a fluorine-18-fluorodeoxyglucose PET scan before randomization and after 16 weeks of antidepressant treatment with either CBT (N=12) or venlafaxine (N=12). Modality-specific and modality-independent regional brain metabolic changes associated with response status were analyzed.
Results:
Response rates were comparable between the CBT (7 12) and venlafaxine (9 12) groups. Response to either treatment modality was associated with decreased glucose metabolism bilaterally in the orbitofrontal cortex and left medial prefrontal cortex, along with increased metabolism in the right occipital-temporal cortex. Changes in metabolism in the anterior and posterior parts of the subgenual cingulate cortex and the caudate differentiated CBT and venlafaxine responders.
Conclusions:
Responders to either treatment modality demonstrated reduced metabolism in several prefrontal regions. Consistent with earlier reports, response to CBT was associated with a reciprocal modulation of cortical-limbic connectivity, while venlafaxine engaged additional cortical and striatal regions previously unreported in neuroimaging investigations.
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.
Fluid flow processes such as drainage and evaporation in porous media are crucial in geological and biological systems. The motion of the displacement front of a moving fluid through multi-phase ...interfaces is often associated with abrupt mechanical energy release, detectable as acoustic emissions (AEs). The exact origin of these pulses and their damping mechanisms are still subjects of debate. Here, we study the characteristics of such AEs during evaporation of water from artificial microfluidic vessels, inspired by the physiology of vascular water-transport in plants. From the extracted settling times of the recorded AEs, we identify three pulse types and attribute their origins to bubble formation, snap-off events and rapid pore invasion. We also show that the resonance frequencies between 10 and 70 kHz present in specific pulse types decrease with increasing vessel radius (ranging from 0.25 to 1.0 mm) and length (ranging from 2.5 to 10.0 mm). Our findings provide insight into evaporation-induced AEs from microfluidic systems, and their potential use in non-invasive inspection or vascular health monitoring.
Although the State–Trait Anxiety Inventory (STAI) is a popular measure of anxiety, some previous research suggests that the trait scale may assess depression, as well as anxiety. The factor structure ...of the trait items was initially examined using factor analytic procedures. Confirmatory factor analytic methods suggested that a hierarchical solution best fit the data, with one overall factor and two lower order factors. The lower order subscales created from this factor solution were examined in a sample of individuals diagnosed with an anxiety disorder. Overall, the results offered good support for the notion that the trait scale of the STAI assesses depression, as well as anxiety. One set of items appeared to assess anxiety and worry, whereas the other assessed sadness and self-deprecation. The two subscales correlated differentially with other measures of anxiety and depression in a manner that was consistent with their content. Finally, diagnostic groups and controls could be meaningfully distinguished on these subscales. Implications for the use of this measure are discussed.
The factor structure, reliability, and validity of the Depression Anxiety Stress Scales (DASS;
S. H. Lovibond & P. F. Lovibond, 1995
) and the 21-item short form of these measures (DASS-21) were ...examined in nonclinical volunteers (
n
= 49) and patients with
Diagnostic and Statistical Manual of Mental Disorders
(4th ed.;
American Psychiatric Association, 1994
) diagnoses of panic disorder (
n
= 67), obsessive-compulsive disorder (
n
= 54), social phobia (
n
= 74), specific phobia (
n
= 17), and major depressive disorder (
n
= 46). This study replicates previous findings indicating that the DASS distinguishes well between features of depression, physical arousal, and psychological tension and agitation and extends these observations to the DASS-21. In addition, the internal consistency and concurrent validity of the DASS and DASS-21 were in the acceptable to excellent ranges. Mean scores for the various groups were similar to those in previous research, and in the expected direction. The implications of these findings are discussed.
Objectives
Public Health Nurses (PHNs) often provide support to women with postpartum depression (PPD) in the absence of specialized training. The objective of this study was to explore the ...experiences of six PHNs who were trained to deliver a group cognitive behavioral therapy (CBT) intervention for PPD in the public health setting, and to describe how learning and delivering this intervention affected their professional roles and personal lives.
Design
This qualitative study employed a phenomenological approach.
Sample
Six PHNs who completed the CBT training program and delivered at least one CBT group in their community.
Measurements
Individual in‐depth interviews were conducted and transcribed verbatim. Transcripts were analyzed according to thematic derivation procedures.
Results
The themes that emerged from the interviews with the PHNs included: (a) components of the CBT training program that nurses most valued, (b) benefits of training for their professional role as a PHN, (c) implications for practice, and (d) using CBT skills in their personal lives.
Conclusions
The provision of CBT training to PHNs may not only positively impact their work with clients with mental illness, but may also have the potential to provide broader clinical and professional benefits for these skilled professionals and their other clients.
Accessible summary
What is known on the subject?
Verbal de‐escalation is an intervention aimed at calmly managing an agitated client to prevent violence. Effective de‐escalation can help reduce the ...use of seclusion and restraint in psychiatric settings.
Despite its importance in practice, there is little agreement on the necessary techniques of de‐escalation and most of the research on the topic is based on expert opinion.
To our knowledge, only one attempt at quantifying de‐escalation skill has been pursued through the German‐language De‐Escalating Aggressive Behaviour Scale (DABS). While the DABS identified seven qualities necessary for de‐escalation, it has not been validated in English and may lack important descriptors.
What this paper adds to existing knowledge?
The present study enhanced the original DABS with best, acceptable and least desirable staff de‐escalation practice descriptions for each of the seven items.
This enhancement of the DABS lead to the creation of the English modified DABS (EMDABS).
The EMDABS was psychometrically validated for use in research and practice: raters could use the EMDABS with a high level of agreement and consistency. Also, the scale appeared to measure a single cohesive construct – de‐escalation.
What are the implications for practice?
With further validation, the EMDABS has potential to be the first English quantitative measure of de‐escalation.
The EMDABS offers seven items, with associated best practice descriptions, that may be used to inform de‐escalation practice.
The EMDABS can be used to evaluate training and education programmes and inform how these programmes and independent de‐escalation practice may be improved.
Introduction
Verbal de‐escalation is crucial to a non‐coercive psychiatric environment. Despite its importance, the literature on de‐escalation is sparse and mostly qualitative. To address this, Nau et al. (2009) quantified de‐escalation by creating the German‐language De‐Escalating Aggressive Behaviour Scale (DABS). The DABS provides seven skills necessary for de‐escalation, however it has not been validated in English and lacks the necessary anchor descriptions to make it useful.
Aim
To modify the DABS to include descriptions of best, acceptable and least desirable staff practice and to validate the English modified DABS (EMDABS).
Method
To develop item descriptions for the EMDABS, 50 conflictual staff–patient interactions were reviewed, summarized and cross‐referenced with the literature (n = 19). Three raters then used the EMDABS to evaluate 272 simulations depicting these interactions.
Results
The EMDABS demonstrated very good inter‐rater reliability ICC (3, 1) = 0.752 and strong internal consistency (α = 0.901). A factor analysis revealed that the seven items were best represented by a single factor.
Discussion
The EMDABS was validated for future use in research and practice. Additional validation and future research directions are discussed.
Implications for practice
The EMDABS holds promise as a quantitative measure of de‐escalation. Its seven items and best practice guidelines have clinical implications for improving practice and training.
Early maladaptive schemas (EMSs) are thought to act as templates for information processing which influence individuals’ emotional reactions to life situations and their styles of interpersonal ...relating. The association between EMSs and psychopathology is also believed to be mediated by the use of maladaptive compensatory coping and deficits in adaptive coping (e.g., avoidance, surrender). As styles of coping, humor may be such a mediator. This study examined correlations between domains of the Young Schema Questionnaire-Short form and subscales of the Humor Styles Questionnaire. A number of EMS domains were associated with reduced use of adaptive affiliative and self-enhancing humor styles and increased use of maladaptive self-defeating humor. In addition, the maladaptive aggressive style of humor was associated with the EMS involving insufficient self-control. The relationship between most EMS domains and depressed mood was mediated by both self-enhancing and self-defeating humor styles.
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