Freda McManus

Establishing evidence-based training in cognitive behavioral therapy: A review of current empirical findings and theoretical guidance.

Cognitive behavior therapys (CBT) demonstrated efficacy has prompted calls for its increased dissemination to routine clinical practice settings. For the widespread dissemination of CBT to be successful in achieving effects similar to the original efficacy trials, there must also be effective dissemination of CBT training practices. However, as yet, CBT training is not evidence-based. This review examines what can be learned from existing research into the efficacy and effectiveness of CBT training. Due to the paucity of research specifically investigating CBT training, CBT effectiveness and dissemination studies are also examined to glean information about potentially effective training practices. In order to draw conclusions about effective training practices, comparisons are drawn between studies according to the clinical outcomes that they achieved. Training approaches are compared according to dose and active training elements, and theoretical models of learning are applied to interpret the findings. The limitations of the existing literature are discussed, as well as recommendations for improving training research to meet the standards evident in treatment trials (e.g., random allocation, control conditions, self-report and blind assessment, and adherence monitoring). Finally, the process of developing efficacious CBT treatment protocols is offered as a template for developing evidence-based CBT training protocols.

Cognitive and non-cognitive factors associated with posttraumatic stress symptoms in mothers of children with type 1 diabetes.

BACKGROUND The experience of having a child diagnosed with type 1 diabetes mellitus (T1DM) can negatively impact on the mothers well-being and trigger posttraumatic stress symptoms. To date, only one study has examined the role of non-cognitive factors in predicting the occurrence of PTSD in parents of children diagnosed with diabetes. However, in the broader PTSD literature is has been shown that both non-cognitive variables and cognitive variables predict PTSD in traumatized populations. AIMS The current study aimed to investigate the relationship of both non-cognitive (trauma severity, psychiatric history and social support) and cognitive variables (negative cognitive appraisals and dysfunctional cognitive appraisals) with PTSD in mothers of children recently diagnosed with diabetes. METHOD A single group survey design and self-report questionnaires were used to investigate the relationship between both non-cognitive (trauma severity, psychiatric history and history of trauma, and social support) and cognitive factors (negative cognitive appraisals and dysfunctional strategies) and PTSD symptoms in mothers of children who had been diagnosed with type 1 diabetes in the last 5 years. RESULTS All cognitive variables were positively associated with PTSD symptoms. In contrast, of the non-cognitive variables, only social support was significantly (negatively) associated with PTSD symptoms. Moreover, regression analysis found that cognitive variables explained variance in PTSD symptoms over and above that contributed by the non-cognitive variables. CONCLUSIONS This supports the cognitive model of PTSD. The implications of the study with regards to early detection of and therapies for PTSD in this population are discussed.

Bipolar risk and mental imagery susceptibility in a representative sample of Chinese adults residing in the community

Background: We need to better understand the cognitive factors associated with risk for bipolar disorders. Recent research suggests that increased susceptibility to mental imagery may be one such factor. However, since this research was primarily conducted with Western students and at a single time-point, it is not known whether the relationship between imagery susceptibility and bipolar symptoms exists across cultures or within the general community, or whether this relationship remains stable over time. Aim: This study evaluated whether Chinese adults identified as being at high (HR) versus low (LR) risk of developing bipolar disorders showed greater mental imagery susceptibility. We aimed to test whether such a relationship was stable over time by measuring imagery characteristics at baseline and at the 7-week follow-up. Method: This prospective study recruited a community sample of N = 80 Chinese adults screened for the absence of neurotic and psychotic disorders. The sample was split into HR (n = 18) and LR (n = 62) groups at baseline based on a criterion cut-off score on a measure of hypomania, the Mood Disorder Questionnaire (MDQ). Participants completed measures of imagery susceptibility and its impact: the Spontaneous Use of Imagery Scale (SUIS) and the Impact of Future Events Scale (IFES), at baseline and 7 weeks later. Results: HR group reported greater tendency to use imagery in daily life (SUIS) and greater emotional impact of prospective imagery (IFES) than LR group at baseline. These results remained stable at follow-up. Conclusion: This study provides preliminary evidence for increased susceptibility to mental imagery in individuals at high risk of bipolar disorders recruited from a community sample of Chinese adults. This extends previous research in Western student samples suggesting that imagery (both levels of use and its emotional impact) may be a cognitive factor with cross-cultural relevance that is stable over time.

Brief report: Maternal posttraumatic stress symptoms are related to adherence to their child’s diabetes treatment regimen

Although research suggests that posttraumatic stress disorder symptoms in relation to physical health diagnoses may be related to poor adherence to treatment regimens, so far, whether parental posttraumatic stress disorder symptoms have an impact on their child’s adherence to insulin-dependent diabetes mellitus treatment has not been investigated. Using self-report questionnaires, the present study found that children of mothers who have posttraumatic stress disorder symptoms in relation to their child’s diagnosis of type I diabetes showed poorer adherence to treatment than the children of mothers without posttraumatic stress disorder. However, this was only the case for younger children (aged 0–8 years) where mothers played a more active role in their child’s treatment.