Patient motivation and adherence in metacognitive therapy for major depressive disorder: an observational study

The aim of this observational study was to examine the predictive and discriminant validity of patient motivation and adherence in metacognitive therapy (MCT) for depression. Motivational development for recovered- and non-recovered patients was also investigated. Motivation in sessions 1, 4, and 7 was measured using the Motivational Interviewing Skill Code 2.5 (MISC) in a 10-session trial of MCT for depression (N = 37). Adherence was assessed with the CBT compliance measure in session 7. The Beck Depression Inventory measured treatment outcome at 3-year follow-up. Recovered patients developed significantly more change talk and taking steps, and less sustain talk, as therapy progressed, compared to non-recovered patients. Evidence of the predictive validity of motivation in sessions 1 and 4 was limited. Higher sustain talk and taking steps in session 7 were significant predictors of more and less depressive symptoms, respectively. There was a moderate-strong correlation between motivation and adherence. The results confirm the predictive value of MISC in sessions 7 of MCT for depression, and establish differential motivational development between recovered and non-recovered patients. Subsequent research should clarify the discriminant validity and temporal relationships between motivation, adherence, and other clinical variables.

No Support for Two Hypotheses About the Communicative Functions of Displaying Disgust: Evidence From Turkey, Norway, Germany, and Croatia

In recent years, researchers have discovered much about how disgust works, its neural basis, its relationship with immune function, its connection with mating, and some of its antecedents and consequents. Despite these advances in our understanding, an under-explored area is how disgust may be used to serve a communicative function, including how individuals might strategically downplay or exaggerate the disgust display in front of different audiences. Here, we generated two hypotheses about potential communicative functions of disgust, and tested these hypotheses in four countries (Turkey, Croatia, Germany, and Norway). We found no evidence in support of either hypothesis in any country. Discussion focuses on the likely falsity of the two central hypotheses, alternative interpretations of our findings, and directions for future research.

Modernization, collectivism, and gender equality predict love experiences in 45 countries

Recent cross-cultural and neuro-hormonal investigations have suggested that love is a near universal phenomenon that has a biological background. Therefore, the remaining important question is not whether love exists worldwide but which cultural, social, or environmental factors influence experiences and expressions of love. In the present study, we explored whether countries' modernization indexes are related to love experiences measured by three subscales (passion, intimacy, commitment) of the Triangular Love Scale. Analyzing data from 9474 individuals from 45 countries, we tested for relationships with country-level predictors, namely, modernization proxies (i.e., Human Development Index, World Modernization Index, Gender Inequality Index), collectivism, and average annual temperatures. We found that mean levels of love (especially intimacy) were higher in countries with higher modernization proxies, collectivism, and average annual temperatures. In conclusion, our results grant some support to the hypothesis that modernization processes might influence love experiences.

Examining the Sexual Double Standards and Hypocrisy in Partner Suitability Appraisals Within a Norwegian Sample

Sexual double standards are social norms that impose greater social opprobrium on women versus men or that permit one sex greater sexual freedom than the other. This study examined sexual double standards when choosing a mate based on their sexual history. Using a novel approach, participants (N = 923, 64% women) were randomly assigned to make evaluations in long-term or short-term mating contexts and asked how a prospective partner's sexual history would influence their own likelihood of having sex (short-term) or entering a relationship (long-term) with them. They were then asked how the same factors would influence the appraisal they would make of male and female friends in a similar position. We found no evidence of traditional sexual double standards for promiscuous or sexually undesirable behavior. There was some evidence for small sexual double standard for self-stimulation, but this was in the opposite direction to that predicted. There was greater evidence for sexual hypocrisy as sexual history tended to have a greater negative impact on suitor assessments for the self rather than for same-sex friends. Sexual hypocrisy effects were more prominent in women, though the direction of the effects was the same for both sexes. Overall, men were more positive about women's self-stimulation than women wee, particularly in short-term contexts. Socially undesirable sexual behavior (unfaithfulness, mate poaching, and jealous/controlling) had a large negative impact on appraisals of a potential suitor across all contexts and for both sexes. Effects of religiosity, disgust, sociosexuality, and question order effects are considered.

Depression, Anxiety, Insomnia, and Quality of Life in a Representative Community Sample of Older Adults Living at Home

Background

The aim of the study was to explore symptoms of anxiety and depression, insomnia, and quality of life in a Norwegian community sample of older adults.

Methods

A representative sample (N = 1069) was drawn from home-dwelling people of 60 years and above, living in a large municipality in Norway (Trondheim).

Results

Based on established cut-off scores, 83.7% of the participants showed no symptoms of anxiety/depression, 12% had mild symptoms, 2.7% moderate symptoms, 1.5% showed severe symptoms of anxiety/depression. A total of 18.4% reported insomnia symptoms. Regarding health-related quality of life, few participants reported problems with self-care, but pain and discomfort were common (59%). Depression/anxiety, insomnia, and health-related quality of life showed moderate to strong associations.

Discussion

The results suggest a close interplay between anxiety/depression, insomnia, and health-related quality of life in older adults.

Metacognitions and brooding predict depressive symptoms in a community adolescent sample

Depressive symptoms are prevalent in adolescence, and girls have higher levels of depressive symptoms and depressive disorder than boys. Rumination and especially brooding, seem to be a central maintaining factor of depressive symptoms, where metacognitions about rumination play a prominent role in maintaining depressive rumination. There is a sex difference in adults in depressive disorder. The current investigation of a high school / community sample of adolescents aged 16-20 from Norway (N = 1198, 62.2% women) found that adolescent women had higher scores than men on all relevant measures: Depressive symptoms, negative and positive metacognitions, pondering, and brooding. A path model for predicting depressive symptoms showed that the major factors for both sexes were negative metacognitions and brooding. The predictors of depressive symptoms were invariant across sex and age groups, suggesting similar underlying mechanisms across these groups. The overall findings suggest that metacognitive therapy may be an efficient intervention for depressive symptoms among adolescents.

Perceived Effectiveness of Flirtation Tactics: The Effects of sex, Mating Context and Individual Differences in US and Norwegian Samples

Flirting involves various signals communicated between individuals. To attract potential mates, men and women exhibit flirtatious behavior to get the attention of, and potentially elicit sexual or romantic interest from, a desired partner. In this first large, preregistered study of judgement of the effectiveness of flirtation tactics based on Sexual Strategies Theory, we considered the effects of flirter's (actor) sex and mating contexts in addition to rater's (participant) sex across two cultures, Norway and the U.S. Culturally relevant covariates such as sociosexuality, extraversion, mate value, age, and religiosity were examined. Participants from Norway (N = 415, 56% women) and the US (N = 577, 69% women) responded to one of four different randomized questionnaires representing a factorial design considering either short-term versus long-term mating context and either female or male sex of actor. We found that sexual availability cues were judged more effective when employed by women in short-term mating contexts. Friendly contact, such as hugs or kissing on the cheek, was not. Cues to generosity and commitment were judged more effective when employed by men in long-term mating contexts. Humor was rated as more effective when used by men and in long-term contexts, and least effective when used by women in short term contexts. However, laughing or giggling at someone's jokes was an effective flirtation tactic for both sexes. Overall, predictions for culturally relevant covariates were not supported, but cultural differences were found in bodily displays, initial contact, and generosity. These findings dovetail neatly with findings from the self-promotion literature, and further support that flirtation is a universal mate signaling strategy.

Metacognitive therapy versus cognitive-behavioral therapy in adults with generalized anxiety disorder: A 9-year follow-up study

OBJECTIVE

Metacognitive therapy (MCT) and cognitive-behavior therapy (CBT) are effective treatments for generalized anxiety disorder. In this study, we followed-up patients who had previously participated in a randomized controlled trial of MCT compared against CBT.

METHOD

We collected 9-year follow-up data on 39 out of 60 original patients (i.e., 65% response rate).

RESULTS

At 9 years, the recovery rates were 57% for MCT and 38% for CBT (completer analysis). Following MCT, 43% maintained their recovery status and a further 14% achieved recovery. Following CBT, the sustained recovery rate was 13%, while a further 25% achieved recovery. Patients in the MCT condition showed significantly more improvement with respect to symptoms of worry and anxiety. In the CBT group, 23.1% were re-diagnosed with generalized anxiety disorder (GAD) compared with 9.5% in the MCT group.

CONCLUSIONS

This follow-up study showed a continuation of gains in both treatments at long-term follow-up, but with outcomes continuing to favor MCT and strengthening its comparative superiority.

Sex differences in human mate preferences vary across sex ratios

A wide range of literature connects sex ratio and mating behaviours in non-human animals. However, research examining sex ratio and human mating is limited in scope. Prior work has examined the relationship between sex ratio and desire for short-term, uncommitted mating as well as outcomes such as marriage and divorce rates. Less empirical attention has been directed towards the relationship between sex ratio and mate preferences, despite the importance of mate preferences in the human mating literature. To address this gap, we examined sex ratio's relationship to the variation in preferences for attractiveness, resources, kindness, intelligence and health in a long-term mate across 45 countries (n = 14 487). We predicted that mate preferences would vary according to relative power of choice on the mating market, with increased power derived from having relatively few competitors and numerous potential mates. We found that each sex tended to report more demanding preferences for attractiveness and resources where the opposite sex was abundant, compared to where the opposite sex was scarce. This pattern dovetails with those found for mating strategies in humans and mate preferences across species, highlighting the importance of sex ratio for understanding variation in human mate preferences.

Perception of workplace social-sexual behavior as sexual harassment post #MeToo in Scandinavia

In this study we examined how people perceive social-sexual behavior of women and men, and how these perceptions were associated with beliefs about the outcomes of the #MeToo movement, sexism, traditional values, and gender equality. In addition, we examined the effect of having experienced sexual harassment on such perceptions. Analyses were performed on a Norwegian snowball social media sample covering 321 women and 168 men, aged 18-59 (M = 33.1). Outcome variables covered perceptions of scenarios that described opposite-sex social-sexual behaviors performed by female and male actors within the workplace environment. Path analysis showed that negative beliefs about the outcomes of the #MeToo movement was the principal predictor for perception of female and male social-sexual behavior as sexual harassment for women and men participants. Traditional values, gender equality, and hostile sexism toward women were all associated with perception of social-sexual behavior as sexual harassment, however the effects of these variables were only indirect and fully accounted for by the effect of negative #MeToo beliefs. For women, having experienced sexual harassment was associated with hostile sexism toward men, but had no effect on the perceptions over and above the effect of the other variables in the model. The predictors on participants' perceptions were highly similar for women and men and for evaluations of female and male actors. Theoretical and methodological implications are discussed.

Sex Differences in Voyeuristic and Exhibitionistic Interests: Exploring the Mediating Roles of Sociosexuality and Sexual Compulsivity from an Evolutionary Perspective

Sociosexuality and sexual compulsivity predict sex differences in voyeuristic interest in the population. In this study, we used a sample of 1113 participants from the UK (46% men) to consider whether sociosexuality and sexual compulsivity interacted to explain these sex differences and whether this relationship extended to the related domain of exhibitionism. In doing so, we tested novel predictions derived from an evolutionary perspective which views voyeuristic and exhibitionistic interest as manifestations of a short-term mating strategy. Participants reported their levels of repulsion toward voyeurism and exhibitionism and their interest in performing such acts under different levels of risk. There were clear sex differences in voyeuristic and exhibitionistic repulsion that were partially mediated by the serial combination of sociosexuality and sexual compulsivity. Examining the sexes separately revealed qualitatively different relationships between sociosexuality and sexual compulsivity when predicting exhibitionistic, but not voyeuristic, repulsion. Combined, sociosexuality and sexual compulsivity also mediated the sex difference in willingness to commit acts of voyeurism, but not exhibitionism, which was equally low for both sexes. The results highlight the role sociosexuality plays in voyeuristic and exhibitionistic interest, which coupled with an evolutionary perspective, may have implications for how we view courtship disorders.

Investigating the emergence of sex differences in jealousy responses in a large community sample from an evolutionary perspective

Sex differences in jealousy responses to sexual and emotional infidelity are robust in samples of heterosexual adults, especially in more gender egalitarian nations. However, investigations of when and how these differences develop have been scant. We applied two forced choice infidelity scenarios in a large community sample of high school students (age 16–19, N = 1266). In line with previous findings on adults using the forced choice paradigm, adolescent males found the sexual aspect of imagined infidelity more distressing than adolescent females did. Nevertheless, there was no effect of age on the jealousy responses, and age did not moderate the sex difference. There were neither any effects of three covariates (having had first sexual intercourse, being in a committed romantic relationship, and sociosexuality), neither as markers of pubertal maturation nor as psychosocial environmental stimuli. Future research needs to investigate even younger samples in order to specify at what age the sex difference in jealousy responses emerges.

Affective Interpersonal Touch in Close Relationships: A Cross-Cultural Perspective

Interpersonal touch behavior differs across cultures, yet no study to date has systematically tested for cultural variation in affective touch, nor examined the factors that might account for this variability. Here, over 14,000 individuals from 45 countries were asked whether they embraced, stroked, kissed, or hugged their partner, friends, and youngest child during the week preceding the study. We then examined a range of hypothesized individual-level factors (sex, age, parasitic history, conservatism, religiosity, and preferred interpersonal distance) and cultural-level factors (regional temperature, parasite stress, regional conservatism, collectivism, and religiosity) in predicting these affective-touching behaviors. Our results indicate that affective touch was most prevalent in relationships with partners and children, and its diversity was relatively higher in warmer, less conservative, and religious countries, and among younger, female, and liberal people. This research allows for a broad and integrated view of the bases of cross-cultural variability in affective touch.

The Function of Casual Sex Action and Inaction Regret: A Longitudinal Investigation

In several recent papers the sex difference in regret predicted by sexual strategies theory has been supported: men more than women report regret passing up short-term sexual opportunities (inaction regret), while women regret having had sexual encounters (action regret). However, the adaptive function of regret, to improve future behavioral choices, has not been tested. In this first longitudinal test of behavioral change following regret, we consider whether regret actually results in adaptive shifts of behavior: will men who regret passing up sex engage in more short-term sex following regret? Will women who regret short-term encounters either choose better quality partners, reduce number of one-night stands or shift their strategy to long-term relationships? Across two waves (NT1 = 399, 65.4% women and NT2 = 222, 66.2% women) students responded to questions about casual sex action regret and inaction regret, along with possible outcomes, intrapersonal traits, and concurrent contextual predictors. There was no clear evidence for the proposed functional shifts in sexual behavior. Casual sex regret was associated with respondent sex and stable individual differences, such as sociosexual attitudes, regret processing and metacognitions, but the effect of these predictors were not consistent across the two waves. Among the tested concurrent contextual predictors, sexual disgust was the most consistent across waves. Regret is considered a gauge of the value and quality of the short-term sexual encounter. However, tentatively we conclude that after this first test of function using longitudinal data, we find no evidence of a mating strategy shifting effect following sexual regret.

Universality of the Triangular Theory of Love: Adaptation and Psychometric Properties of the Triangular Love Scale in 25 Countries

The Triangular Theory of Love (measured with Sternberg's Triangular Love Scale - STLS) is a prominent theoretical concept in empirical research on love. To expand the culturally homogeneous body of previous psychometric research regarding the STLS, we conducted a large-scale cross-cultural study with the use of this scale. In total, we examined more than 11,000 respondents, but as a result of applied exclusion criteria, the final analyses were based on a sample of 7332 participants from 25 countries (from all inhabited continents). We tested configural invariance, metric invariance, and scalar invariance, all of which confirmed the cultural universality of the theoretical construct of love analyzed in our study. We also observed that levels of love components differ depending on relationship duration, following the dynamics suggested in the Triangular Theory of Love. Supplementary files with all our data, including results on love intensity across different countries along with STLS versions adapted in a few dozen languages, will further enable more extensive research on the Triangular Theory of Love.

Change in personality traits and facets (Revised NEO Personality Inventory) following metacognitive therapy or cognitive behaviour therapy for generalized anxiety disorder: Results from a randomized controlled trial

OBJECTIVE

We aimed to discover whether psychological treatment for generalized anxiety disorder (GAD) was associated with changes in the big five personality traits and their facets.

METHOD

Patients with GAD were randomized either to receive cognitive behaviour therapy (CBT, n = 28) or metacognitive therapy (MCT, n = 32). Before and after 12 sessions of treatment, 55 of the patients completed the full Revised NEO Personality Inventory (NEO-PI-R) (240 items).

RESULTS

Patients with GAD showed a personality profile with high Neuroticism and lower Extraversion and Openness. Treatment across conditions was associated with significant reduction in Neuroticism and increased Extraversion and Openness. There were no significant changes in Agreeableness and Conscientiousness. However, their facets of Actions and Trust increased. Post-treatment levels of neuroticism were associated with symptoms of worry before and after therapy, whereas post-treatment extraversion was related to depressive symptoms after treatment. MCT was associated with greater reduction of Neuroticism than CBT.

CONCLUSIONS

This is the first study to show that efficient treatment for a specific disorder resulted in changes across NEO-PI-R factors and facets and that more efficient treatment results in greater change. If this reflects a reduced trait vulnerability for mental disorder, this might provide evidence of relapse prevention.

Validity of a Norwegian version of the Desire Thinking Questionnaire (DTQ): Associations with problem drinking, nicotine dependence and problematic social media use

The aim of the current study was to test the validity of the Norwegian version of the Desire Thinking Questionnaire (DTQ). Three cross-sectional surveys were conducted investigating the psychometric properties of the DTQ in alcohol use (N = 588), nicotine use (N = 446) and social media use (N = 359). Principal components and confirmatory factor analyses supported the original two-factor solution consisting of verbal perseveration (VP) and imaginal prefiguration (IP); however, one item was removed to obtain good fit. Internal consistency was acceptable. Both IP and VP showed significant correlations with problem drinking, nicotine dependence and problematic social media use. Regression analyses, controlling for demographics and negative affect, found IP and VP to be significantly associated with all dependent variables. The results confirm that desire thinking is an important construct across different addictive behaviours.

The meaning of service questionnaire and its association with psychological growth among Veterans

Few studies have investigated what soldiers find meaningful after being exposed to highly stressful events and what positive effects they might have in the aftermath. This study reports the psychometric properties of a newly developed questionnaire, Meaning of Service (MoS), and its application to the study of how strongly meaning-making processes are associated with psychological growth. One hundred eighty-four Norwegian Air Force Veterans who have participated in various missions abroad in different branches of the military completed the MoS questionnaire along with other scales reflecting psychological growth, hardiness, resilience, stress, and exposure, as well as personal and mission characteristics. The principal component analysis mainly identified three major meaning themes as expected from previous qualitative research (Confirmation of ability, Cohesion of peers, and Significance of effort). The hierarchical regression analysis showed that all three meaning themes and two coping strategies were associated with psychological growth, and that Confirmation of ability (coping and recognition of coping) seems particularly important to enhance Veterans' prospects of psychological growth. Future research directions are proposed including suggestions for minor modifications of the questionnaire.

Positive and negative metacognitions about alcohol: Validity of the Norwegian PAMS and NAMS

A growing body of research has demonstrated that metacognitions are associated with alcohol use and other addictive behaviours. In the present study (N = 588), we investigated the validity of the Positive Alcohol Metacognitions Scale (PAMS) and the Negative Alcohol Metacognitions Scale (NAMS). The results supported two-factor solutions for both the PAMS and NAMS, but three items from the PAMS were deleted. These metacognitive measures distinguished between participants in low, moderate, and high-risk groups. Significant correlations were observed with alcohol use, and both PAMS and NAMS were unique significant predictors of alcohol use whilst controlling for demographics and negative affect. The validity of the Norwegian versions of PAMS and NAMS confirm previous findings and provide further support for the importance of metacognitions in alcohol use.

Protective and Vulnerability Factors in Self-Esteem: The Role of Metacognitions, Brooding, and Resilience

The aim of the current study was to explore protective (resilience) and vulnerability factors (dysfunctional metacognitions and brooding) for self-esteem. A total of 725 participants were included in a cross-sectional study. A path analysis revealed five paths to self-esteem. The three main paths were as follows: (1) symptoms −> metacognitions −> brooding −> self-esteem, (2) symptoms −> resilience −> self-esteem, and (3) a direct path from symptoms. The first path corresponds with the metacognitive model of psychopathology and suggests that triggers in the form of anxiety and depression symptoms lead to the activation of metacognitive beliefs, which in turn activates brooding in response to these triggers. When a person engages in brooding, this makes the person vulnerable to experiencing low self-esteem. The second path suggests a protective role of resilience factors. The overall model explained 55% of the variance in self-esteem. Regression analysis found that unique predictors of self-esteem were female sex, symptoms of anxiety and depression, brooding, and resilience. These findings have possible clinical implications, as treatment may benefit from addressing both protective and vulnerability factors in individuals suffering from low self-esteem.

Sex Differences in Mate Preferences Across 45 Countries: A Large-Scale Replication

Considerable research has examined human mate preferences across cultures, finding universal sex differences in preferences for attractiveness and resources as well as sources of systematic cultural variation. Two competing perspectives-an evolutionary psychological perspective and a biosocial role perspective-offer alternative explanations for these findings. However, the original data on which each perspective relies are decades old, and the literature is fraught with conflicting methods, analyses, results, and conclusions. Using a new 45-country sample (N = 14,399), we attempted to replicate classic studies and test both the evolutionary and biosocial role perspectives. Support for universal sex differences in preferences remains robust: Men, more than women, prefer attractive, young mates, and women, more than men, prefer older mates with financial prospects. Cross-culturally, both sexes have mates closer to their own ages as gender equality increases. Beyond age of partner, neither pathogen prevalence nor gender equality robustly predicted sex differences or preferences across countries.

Metacognitive Therapy for Depression: A 3-Year Follow-Up Study Assessing Recovery, Relapse, Work Force Participation, and Quality of Life

A major challenge in the treatment of depression has been high relapse rates following treatment. The current study reports results from a 3-year follow-up of patients treated with metacognitive therapy (MCT). Thirty-four of the 39 patients enrolled in the original study attended assessment (participation rate of 87%). There were large reductions in symptoms of depression, anxiety, interpersonal problems, and worry, as well as metacognitive beliefs. Three patients fulfilled diagnostic criteria for axis-I disorders: one with depression and two with generalized anxiety disorder. Sixty percent had not experienced any new depressive episodes in the 3-year follow-up period, and the static relapse rates were low (11-15%). Recovery rates ranged from 69 to 97% depending upon the four different criteria used. Nevertheless, 26% had sought out treatment for depression or other psychological difficulties. Most patients (70%) had experienced negative life events in the follow-up period, but these events did not influence current depression severity. Return to work outcomes were encouraging, as eight out of 13 patients that had been on benefits were no longer receiving benefits. Life satisfaction ratings showed mean scores around 70 (on a 0-100 scale) and showed a moderate to strong negative correlation with depression severity. In conclusion, MCT appears to be promising with respect to long-term effect. Randomized controlled trials should investigate if the long-term effect of MCT surpasses that of other evidence-based treatments for depression.

Mate preference priorities in the East and West: A cross-cultural test of the mate preference priority model

OBJECTIVE

Mate choice involves trading-off several preferences. Research on this process tends to examine mate preference prioritization in homogenous samples using a small number of traits and thus provide little insight into whether prioritization patterns reflect a universal human nature. This study examined whether prioritization patterns, and their accompanying sex differences, are consistent across Eastern and Western cultures.

METHOD

In the largest test of the mate preference priority model to date, we asked an international sample of participants (N = 2,477) to design an ideal long-term partner by allocating mate dollars to eight traits using three budgets. Unlike previous versions of the task, we included traits known to vary in importance by culture (e.g., religiosity and chastity).

RESULTS

Under low budget conditions, Eastern and Western participants differed in their mate dollar allocation for almost every trait (average d = 0.42), indicating that culture influences prioritization. Despite these differences, traits fundamental for the reproductive success of each sex in the ancestral environment were prioritized by both Eastern and Western participants.

CONCLUSION

The tendency to prioritize reproductively fundamental traits is present in both Eastern and Western cultures. The psychological mechanisms responsible for this process produce similar prioritization patterns despite cross-cultural variation.

A Randomized Controlled Trial of Metacognitive Therapy for Depression: Analysis of 1-Year Follow-Up

This paper reports the 1-year follow-up results from a randomized controlled trial (RCT), which examined the efficacy of metacognitive therapy (MCT) for unipolar depression compared to a waiting condition. Thirty-nine patients with major depression were offered MCT and were divided into two conditions; immediate MCT with 10 weekly sessions or a waiting period that had a 10-week delayed MCT start. Two participants dropped out during the waiting condition. Thirty-four patients participated in the follow-up assessment. Based on the intent-to-treat sample and all patients, 67% were classified as recovered, 13% improved, and 20% were unchanged at 1-year follow-up. For the completers sample 73% recovered, 12% improved, and 15% were unchanged. Five of the 31 patients (13%) that were in remission at post-treatment experienced relapse at 1-year follow-up. Within-group effect sizes were large for reductions in symptoms of depression (d = 2.09) and anxiety (d = 1.16) at 1-year. Treatment response was associated with reductions in rumination, worry, and metacognitive beliefs as predicted by the metacognitive model, but reductions in metacognitions independently predicted reductions in depression scores from pre-treatment to 1-year follow-up. The results suggest that treatment gains are stable at 1-year follow-up. The study sets the stage for future research, which should evaluate MCT over a longer term and compare it with active treatments using suitably powered RCTs.

Gender differences in factors associated with symptoms of depression among high school students: an examination of the direct and indirect effects of insomnia symptoms and physical activity

Objective

Scant research exists on the gender-specific association between physical activity, insomnia symptoms and depressive symptoms among adolescents. The present study investigates the direct and indirect association of insomnia and physical activity with symptoms of depression.

Design

In a community-based sample (N = 1485) we investigated factors associated with symptoms of depression focusing on insomnia. The study also included measures of physical activity and controlled for parental work- and sexual minority status. Body mass Index (BMI) was calculated for a sub-sample (n = 617) reporting weight and height.

Results

The results showed that self-reported insomnia was highly prevalent, and the association between insomnia and depression was strong. The association between insomnia and depression was significantly stronger for girls than for boys. The effect of physical activity was substantially weaker compared to insomnia. Insomnia mediated the relationship between physical activity and depression for both boys and girls. Despite expectation based on the existing literature, BMI showed no association with symptoms of depression or physical activity.

Conclusion

The results address the importance of a gender-specific approach when investigating mental health among adolescents. Given the high prevalence, interventions aimed at reducing insomnia is important in the prevention of mental illness, especially among girls.

Worry and Metacognitions as Predictors of Anxiety Symptoms: A Prospective Study

Both worry and metacognitive beliefs have been found to be related to the development of anxiety, but metacognitive theory (Wells and Matthews, 1994; Wells, 2009) suggest that metacognitive beliefs may play a more prominent role. The aim of the present prospective study was to examine whether worry, metacognitive beliefs or the interaction between worry and metacognitive beliefs, were the best predictor of anxiety over time, utilizing a longitudinal, prospective study design. An undergraduate student sample (N = 190) was assessed on measures of worry (PSWQ), metacognitive beliefs (MCQ-30) and anxiety (BAI) at three points in time over a 7-month period. A mixed-model analysis revealed that both worry and metacognitive beliefs predicted development of anxiety, independently of each other, with no indication of an interaction-effect (PSWQ ^* MCQ-30). Further, analyses of the MCQ-30 subscales indicated that negative metacognitive beliefs may be particularly important in the development of anxiety. While gender was correlated with worry, gender predicted anxiety beyond the effect of worry. Taken together, the results imply that both worry and metacognitive beliefs play a prominent role for the development of anxiety.

Oxytocin and vulnerable romantic relationships

Oxytocin (OT) has been implicated in the formation and maintenance of various social relationships, including human romantic relationships. Competing models predict, alternatively, positive or negative associations between naturally-occurring OT levels and romantic relationship quality. Empirical tests of these models have been equivocal. We propose a novel hypothesis ('Identify and Invest') that frames OT as an allocator of psychological investment toward valued, vulnerable relationships, and test this proposal in two studies. In one sample of 75 couples, and a second sample of 148 romantically involved individuals, we assess facets of relationships predicting changes in OT across a thought-writing task regarding one's partner. In both studies, participants' OT change across the task corresponded positively with multiple dimensions of high relationship involvement. However, increases in participants' OT also corresponded to their partners reporting lower relationship involvement. OT increases, then, reflected discrepancies between assessments of self and partner relationship involvement. These findings are robust in a combined analysis of both studies, and do not significantly differ between samples. Collectively, our findings support the 'Identify and Invest' hypothesis in romantic couples, and we argue for its relevance across other types of social bonds.

Metacognitive Therapy for Depression in Adults: A Waiting List Randomized Controlled Trial with Six Months Follow-Up

This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression. Thirty-nine patients with depression were randomly assigned to immediate MCT (10 sessions) or a 10-week wait list period (WL). The WL-group received 10 sessions of MCT after the waiting period. Two participants dropped out from WL and none dropped out of immediate MCT treatment. Participants receiving MCT improved significantly more than the WL group. Large controlled effect sizes were observed for both depressive (d = 2.51) and anxious symptoms (d = 1.92). Approximately 70–80% could be classified as recovered at post-treatment and 6 months follow-up following immediate MCT, whilst 5% of the WL patients recovered during the waiting period. The results suggest that MCT is a promising treatment for depression. Future controlled studies should compare MCT with other active treatments.

An evaluation of combined narrative exposure therapy and physiotherapy for comorbid PTSD and chronic pain in torture survivors

INTRODUCTION

Torture is associated with adverse health consequences, with especially high rates of PTSD, depression and chronic pain. Despite increased awareness of the relationship between pain and posttraumaticsymptoms, and the accompanying need for effective treatment strategies, few studies have examined an integrated treatment of comorbid PTSD and pain.

METHODS

In this study, using an A-B case series design with three and six month follow-up, six refugee torture survivors with comorbid PTSD, depression and chronic pain received 20 sessions of Narrative Exposure Therapy (NET) and 10 sessions of physiotherapy. Outcome variables included symptoms of PTSD and depression, pain intensity, physical functioning and quality of life. Symptoms of PTSD and pain were also rated after each treatment session.

RESULTS

Two patients achieved clinically significant reduction in symptoms of PTSD. Only one patient achieved clinically significant change in depressive symptoms, and two experienced clinically significant reduction in pain intensity. Clinical descriptions of the course of treatment for all patients are provided.

DISCUSSION AND CONCLUSIONS

Despite its limitations, the study suggests that some torture survivors who suffer high symptom loads may benefit from a combined treatment of NET and physiotherapy. Appreciating individual differences and how they affect treatment can provide valuable insight and inform clinicians working with torture survivors. Directions for future researchregarding the improvement of rehabilitation strategies of torture survivors are discussed, and highlighted through descriptions from the six therapy cases.

Can disability predict treatment outcome among traumatized refugees?

The aim of the present study was to examine the influence of disability on changes in symptoms of PTSD, anxiety, and depression among treatment-seeking traumatized refugees. Eighty-one refugees participated in different rehabilitation programs. PTSD symptomatology was assessed by the HTQ-IV and symptoms of depression and anxiety were assessed by the HSCL-25. Disability was assessed by the WHODAS 2.0 before treatment. Following treatment, no statistically significant changes in PTSD, depression, and anxiety symptom scores were observed. Disability in the domain 'getting along' was a significant predictor of PTSD scores following treatment, when controlling for baseline scores. Neither total disability nor individual disability domains predicted any other symptom changes. Living with one's partner did, however, seem to be a consistent and significant predictor of treatment outcome. The results are discussed in terms of clinical implications and future research needs.

Sexual Regret

The current study sought to answer three key questions about explaining the emotion of regret in the domain of casual sex: Are sex differences in sexual regret robust or attenuated in a highly egalitarian culture? What proximate psychological variables might explain sex differences in sexual regret? And what accounts for within-sex variation in experiences of sexual regret about casual sex. We conducted a study of 263 Norwegian students (ages 19-37) who reported how much they regretted having either engaged in, or passed up, their most recent casual sexual experience. Sex differences in sexual regret are not attenuated in this sexually egalitarian culture. The study revealed sex differences in worries about pregnancy, STIs, and reputation; however, these predictors did not succeed in accounting for the sex differences in regret engaging in casual sex. Sexual gratification and socio-sexual orientation both predicted the sex differences in casual sex regret. In contrast, only socio-sexual orientation attenuated the sex difference in regret passing up casual sex. Predictors of within-sex variation in casual sexual regret included worry about sexual reputation, experienced gratification during the encounter, and socio-sexual orientation. Discussion focuses on implications for the psychological design features of this relatively neglected emotion.