Psychology - Collected Works
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ItemCurrent PTSD symptomatology distorts memory for past symptoms(Elsevier, 2019-02-20)Clinicians often rely on clients’ retrospective reports of past symptoms to diagnose and treat Posttraumatic Stress Disorder (PTSD). However, there is limited research investigating memory for past PTSD symptoms. We asked sexual assault survivors to report their PTSD symptoms and then recall them 6 months later. Overall, symptom recall was consistent with initial reports. However, after dividing participants into PTSD-positive and negative groups, we found that people who were PTSD-negative at follow-up underestimated past PTSD symptom severity while people who were PTSD-positive overestimated past symptoms. For example, 2.8% of PTSD-negative participants versus 15.9% of PTSD-positive participants recalled experiencing 20+ more points on the PCL-5 at follow-up than at initial assessment. Further, people who adjusted over time greatly underestimated past symptoms unlike those who remained PTSD-positive. Our findings have important theoretical and clinical implications because they show that current symptom severity may influence the memory reconstruction of prior levels of adjustment.
ItemA randomised controlled trial of guided internet-based cognitive behavioural therapy for perfectionism: Effects on psychopathology and transdiagnostic processes(Elsevier, 2019-03-30)Background and objectives Perfectionism is a transdiagnostic process that has been associated with a range of psychopathology and also with other transdiagnostic processes. We have previously shown that guided internet-based cognitive behavioural therapy (ICBT) can reduce symptoms of dysfunctional perfectionism, however, no impact was observed on symptoms of depression and anxiety. Here we explore the impact of guided ICBT for perfectionism on symptoms of other associated psychopathology, specifically obsessive-compulsive disorder (OCD) and eating disorders, and also on other associated transdiagnostic processes (self-esteem, intolerance of uncertainty, and self-compassion). Methods Participants who presented with clinical levels of perfectionism were randomised to an experimental group that received the intervention (n = 62), or a wait list control group (n = 58). Questionnaires assessing symptoms of OCD, eating disorders, self-esteem, intolerance of uncertainty, and fear of self-compassion were completed pre-intervention, post-intervention (12 weeks), and at follow-up (24 weeks). Between group effect sizes are reported. Results The intervention led to significant decreases in symptoms of OCD (d = −0.9; CI: -1.4, −0.4) and eating disorders (d = −0.6; CI: -1.0, −0.1), and had an impact on other transdiagnostic processes resulting in increased self-esteem (d = 0.7; CI: 0.2, 1.2), decreases in intolerance of uncertainty (d = −0.9; CI: -1.4, −0.4), and fear of self-compassion (d = −0.8; CI: -1.3, −0.3). At follow-up changes were maintained in symptoms of OCD (d = −1.3; CI: -1.8, −0.8), disordered eating (d = −0.7; CI: -1.2, −0.2), intolerance of uncertainty (d = −0.8; CI: -1.2, −0.3), and fear of self-compassion (d = −1.0; CI: -1.5, −0.5). Conclusions Guided ICBT for perfectionism improves associated psychopathology and transdiagnostic processes. ClinicalTrials.gov registration no. NCT02756871.
ItemPredictors of outcome in cognitive behavioural therapy for eating disorders: An exploratory study(Elsevier, 2019-02-15)Objective Early decrease in symptoms is a consistent predictor of good treatment outcome across all eating disorders. The current study explored the predictive value of novel early change variables in a transdiagnostic, non-underweight sample receiving 10-session cognitive behavioural therapy. Method Participants who reported bingeing and/or purging in the week preceding baseline assessment (N = 62) were included in analyses. Early change variables were calculated for novel (body image flexibility, body image avoidance, body checking, and fear of compassion) and established predictors (behavioural symptoms and therapeutic alliance). Outcomes were global eating disorder psychopathology and clinical impairment at posttreatment and three-month follow-up. Intent-to-treat analyses were conducted using linear regression, adjusting for baseline values of the relevant outcome and early change in behavioural symptoms. Results Early improvement in body image flexibility was the most consistent predictor of good outcome. Early change in body image avoidance and the fear of expressing and receiving compassion to/from others were significant predictors in some analyses. Discussion Novel early change variables were significant predictors of eating disorder outcomes in this exploratory study. Model testing is required to understand the exact mechanisms by which these variables impact on outcomes, and whether there is potential benefit of modifying existing protocols.
ItemReadiness to change and commitment as predictors of therapy compliance in adolescents with Delayed Sleep-Wake Phase Disorder(Elsevier, 2019-03)Objectives Recent evidence indicates that adolescents' motivation to change sleep-wake patterns is low, despite significant impact of adolescent sleep problems on many areas of daytime functioning. The aim of the present study is to evaluate components of adolescents' motivation, and subsequent changes in behaviour. Methods Fifty-six adolescents, aged 13–23 (M = 15.8 ± 2.3 y; 38% m) diagnosed with Delayed Sleep-Wake Phase Disorder (DSWPD) underwent three therapy sessions involving bright light therapy to phase advance sleep patterns. Adolescents were instructed to advance wake-up times by 30-min daily. Motivation ratings of desire, ability, reason, need and commitment to change sleep patterns were taken at baseline. Sleep diaries were taken at the end of treatment session 1, with sequentially earlier wake-up times in 30-min intervals indicating compliance. Results At the outset of therapy, adolescents indicated strong desire, reasons and need, yet moderate ability and commitment to advance their sleep-wake patterns. Following therapy, sleep-onset times were significantly advanced, total sleep time increased and sleep latency decreased (all p < 0.05). Therapy lasted 6–27 days (M = 13.9 ± 4.5) and clients complied for approximately half the time (between 3 and 15 days; M = 8.8 ± 2.7). Commitment was associated with ability (r = 0.66, p < 0.001) but not desire, reason or need (all p > 0.05). Adolescents' desire to change (r = 0.30, p = 0.03) and commitment (r = 0.30, p = 0.03) were positively correlated with behaviour change, but their need, ability and reasons were not. A mediation analysis showed that ability and desire were important in predicting behaviour change, by total effects through commitment (ie, indirectly and directly). Conclusion Our findings suggest that the total effects of ability (ie, confidence) and desire to change are the best predictors of behavioural changes, thus clinicians should focus on these components of the readiness to change model when undertaking treatments with sleep-disordered adolescents.
ItemMedia multitasking, impulsivity and dual task ability(Elsevier, 2018-11-09)With recent developments in technology, media multitasking is an ever-increasing phenomenon. Although most studies associate media multitasking with high impulsivity and poorer cognitive performance, findings in the literature have been mixed, with some studies suggesting the opposite. The aim of this study was to investigate the relationship between media multitasking and the capacity to exert inhibitory control, as well as the ability to multitask in a multisensory setting. Results showed that media multitasking was associated with high attentional impulsivity and lower initiatory self-control, but not with inhibitory self-control. Relatedly, heavy media multitaskers were slower and showed more omission errors on the go/no-go task, suggestive of inattention; however, they were better at inhibiting already initiated motoric responses in the stop signal task. Media multitasking was further associated with faster responses when a letter and a tone task were temporally separated, but not when they were presented closer in time. Taken together, the results suggest a more nuanced relationship between media multitasking, personality and cognitive ability than has previously been thought. This has important real life implications for media multitasking, showing both advantages and disadvantages.
ItemUsing Explicit Case Formulation to Improve Cognitive Processing Therapy for PTSD(Elsevier, 2018-04-18)We investigated the utility of explicit case formulation (CF) within Cognitive Processing Therapy (CPT) for individuals with posttraumatic stress disorder (PTSD). An uncontrolled pre-posttreatment design was used. Participants attended 12–16 weekly sessions of CPT with explicit CF, where CF guided treatment length and treatment components. Treatment was completed by 19 of the 23 participants who started therapy. Results revealed significant reductions in PTSD and depression severity as well as unhelpful PTSD-related beliefs from pre- to posttreatment (ds between 1.10 – 1.92) and treatment gains were maintained at 3-month follow-up. Of the participants available at posttreatment for assessment, 69% (n = 11/16) met good end-state functioning for PTSD and 62% (n = 8/13) did so at follow-up. Finally, 72% (n = 13/18) of those interviewed at posttreatment no longer met criteria for PTSD and this was found for 93% of those assessed at follow-up (n = 14/15). Treatment, and CF in particular, was found to be acceptable by participants. Explicit case formulation did not interfere with positive outcomes of Cognitive Processing Therapy for PTSD. Further clinical implications and future directions for research are discussed.