Cognitive behaviour therapy for low self-esteem: A preliminary randomized controlled trial in a primary care setting

Background and Objectives Low self-esteem (LSE) is associated with psychiatric disorder, and is distressing and debilitating in its own right. Hence, it is frequent target for treatment in cognitive behavioural interventions, yet it has rarely been the primary focus for intervention. This paper reports on a preliminary randomized controlled trial of cognitive behaviour therapy (CBT) for LSE using Fennell’s (1997) cognitive conceptualisation and transdiagnostic treatment approach ( [Fennell, 1997] and [Fennell, 1999]). Methods Twenty-two participants were randomly allocated to either immediate treatment (IT) (n = 11) or to a waitlist condition (WL) (n = 11). Treatment consisted of 10 sessions of individual CBT accompanied by workbooks. Participants allocated to the WL condition received the CBT intervention once the waitlist period was completed and all participants were followed up 11 weeks after completing CBT. Results The IT group showed significantly better functioning than the WL group on measures of LSE, overall functioning and depression and had fewer psychiatric diagnoses at the end of treatment. The WL group showed the same pattern of response to CBT as the group who had received CBT immediately. All treatment gains were maintained at follow-up assessment. Limitations The sample size is small and consists mainly of women with a high level of educational attainment and the follow-up period was relatively short. Conclusions These preliminary findings suggest that a focused, brief CBT intervention can be effective in treating LSE and associated symptoms and diagnoses in a clinically representative group of individuals with a range of different and co-morbid disorders.

Self-esteem and coping in children with developmental coordination disorder

This study investigated self-esteem in children with developmental coordination disorder (DCD). Fifteen children between the ages of 8 and 12 years diagnosed with DCD were compared with a typically developing group comprising 30 children with average and good motor abilities, using measures of perceived competence, social support and self-esteem. The types of coping strategy generated in response to example vignettes were also compared. There was no significant difference between the groups in global self-esteem, but the children with DCD reported lower athletic and scholastic competence than their typically developing peers. No difference was found between the groups in level of perceived social support. The DCD group generated fewer coping strategies overall, but more passive and avoidant strategies than the typically developing children. The implications of the study are discussed with regard to future research directions, such as the investigation of the effects of motor skill intervention on self-esteem and the development of strategies to protect children's self-esteem.

Cognitive-behavior therapy for low self-esteem: a case example

Low self-esteem is a common, disabling, and distressing problem that has been shown to be involved in the etiology and maintenance of range of Axis I disorders. Hence, it is a priority to develop effective treatments for low self-esteem. A cognitive-behavioral conceptualization of low self-esteem has been proposed and a cognitive-behavioral treatment (CBT) program described (Fennell, 1997, 1999). As yet there has been no systematic evaluation of this treatment with routine clinical populations. The current case report describes the assessment, formulation, and treatment of a patient with low self-esteem, depression, and anxiety symptoms. At the end of treatment (12 sessions over 6 months), and at 1-year follow-up, the treatment showed large effect sizes on measures of depression, anxiety, and self-esteem. The patient no longer met diagnostic criteria for any psychiatric disorder, and showed reliable and clinically significant change on all measures. As far as we are aware, there are no other published case studies of CBT for low self-esteem that report pre- and posttreatment evaluations, or follow-up data. Hence, this case provides an initial contribution to the evidence base for the efficacy of CBT for low self-esteem. However, further research is needed to confirm the efficacy of CBT for low self-esteem and to compare its efficacy and effectiveness to alternative treatments, including diagnosis-specific CBT protocols.

Identifying behavioural predictors of small power electricity consumption in office buildings

It is widely accepted that there is a gap between design energy and real world operational energy consumption. The behaviour of occupants is often cited as an important factor influencing building energy performance. However, its consideration, both during design and operation, is overly simplistic, often assuming a direct link between attitudes and behaviour. Alternative models of decision making from psychology highlight a range of additional influential factors and emphasise that occupants do not always act in a rational manner. Developing a better understanding of occupant decision making could help inform office energy conservation campaigns as well as models of behaviour employed during the design process. This paper assesses the contribution of various behavioural constructs on small power consumption in offices. The method is based upon the Theory of Planned Behaviour (TPB) which assumes that intention is driven by three factors: attitude, subjective norms, and perceived behavioural control, but we also consider a fourth construct: habit measured through the Self- Report Habit Index (SRHI). A questionnaire was issued to 81 participants in two UK offices. Questionnaire results for each behavioural construct were correlated against each participant’s individual workstation electricity consumption. The intentional processes proposed by TPB could not account for the observed differences in occupants’ interactions with small power appliances. Instead, occupants were interacting with small power “automatically”, with habit accounting for 11% of the variation in workstation energy consumption. The implications for occupant behaviour models and employee engagement campaigns are discussed.

Obsessive Compulsive Treatment Efficacy Trial (OCTET) comparing the clinical and cost effectiveness of self-managed therapies: study protocol for a randomised controlled trial

Background: UK National Institute of Health and Clinical Excellence guidelines for obsessive compulsive disorder (OCD) specify recommendations for the treatment and management of OCD using a stepped care approach. Steps three to six of this model recommend treatment options for people with OCD that range from low-intensity guided self-help (GSH) to more intensive psychological and pharmacological interventions. Cognitive behavioural therapy (CBT), including exposure and response prevention, is the recommended psychological treatment. However, whilst there is some preliminary evidence that self-managed therapy packages for OCD can be effective, a more robust evidence base of their clinical and cost effectiveness and acceptability is required. Methods/Design: Our proposed study will test two different self-help treatments for OCD: 1) computerised CBT (cCBT) using OCFighter, an internet-delivered OCD treatment package; and 2) GSH using a book. Both treatments will be accompanied by email or telephone support from a mental health professional. We will evaluate the effectiveness, cost and patient and health professional acceptability of the treatments. Discussion: This study will provide more robust evidence of efficacy, cost effectiveness and acceptability of self-help treatments for OCD. If cCBT and/or GSH prove effective, it will provide additional, more accessible treatment options for people with OCD.

Indicators of nitrate in wetland surface and soil-waters: interactions of vegetation and environmental factors

This paper describes a new bio-indicator method for assessing wetland ecosystem health: as such, the study is particularly relevant to current legislation such as the EU Water Framework Directive, which provides a baseline of the current status Of Surface waters. Seven wetland sites were monitored across northern Britain, with model construction data for predicting, eco-hydroloplical relationships collected from five sites during 1999, Two new sites and one repeat site were monitored during 2000 to provide model test data. The main growing season for the vegetation, and hence the sampling period, was May-August during both years. Seasonal mean concentrations of nitrate (NO3-) in surface and soil water samples during 1999 ranged from 0.01 to 14.07 mg N 1(-1), with a mean value of 1.01 mg N 1(-1). During 2000, concentrations ranged from trace level (<0.01 m- N 1(-1)) to 9.43 mg N 1(-1), with a mean of 2.73 mg N 1(.)(-1) Surface and soil-water nitrate concentrations did not influence plant species composition significantly across representative tall herb fen and mire communities. Predictive relationships were found between nitrate concentrations and structural characteristics of the wetland vegetation, and a model was developed which predicted nitrate concentrations from measures of plant diversity, canopy structure and density of reproductive structures. Two further models, which predicted stem density and density of reproductive structures respectively, utilised nitrate concentration as one of the independent predictor variables. Where appropriate, the models were tested using data collected during 2000. This approach is complementary to species-based monitoring, representing a useful and simple too] to assess ecological status in target wetland systems and has potential for bio-indication purposes.

Fast training of self organizing maps for the visual exploration of molecular compounds

Visual exploration of scientific data in life science area is a growing research field due to the large amount of available data. The Kohonen’s Self Organizing Map (SOM) is a widely used tool for visualization of multidimensional data. In this paper we present a fast learning algorithm for SOMs that uses a simulated annealing method to adapt the learning parameters. The algorithm has been adopted in a data analysis framework for the generation of similarity maps. Such maps provide an effective tool for the visual exploration of large and multi-dimensional input spaces. The approach has been applied to data generated during the High Throughput Screening of molecular compounds; the generated maps allow a visual exploration of molecules with similar topological properties. The experimental analysis on real world data from the National Cancer Institute shows the speed up of the proposed SOM training process in comparison to a traditional approach. The resulting visual landscape groups molecules with similar chemical properties in densely connected regions.

Neocolonialism and international law, with specific reference to customary counterterrorism obligations and the principle of self-defence

Has international law ever, and, if it has not, can it ever, truly freed itself from the strictures of neocolonialism and the drive by a privileged elite to dominate the world scene? This article begins by inquiring into the nature of neocolonialism and, in so doing, pays particular attention to the writings of former Ghanaian President Kwame Nkrumah. It then proceeds to determine how neocolonialist designs surface in international law today by briefly looking at two aspects of international law in particular, namely customary international law, with specific reference to the counterterrorism context, and the principle of self-defence. In the final analysis, this article argues for a necessary and eternal scepticism of international law and the agendas of its privileged gatekeepers. Like classic State power, it opens itself to, and often operates as, neocolonial overreach, and to quote Nkrumah, “[t]he cajolement, the wheedlings, the seductions and the Trojan horses of neo-colonialism must be stoutly resisted, for neo-colonialism is a latter-day harpy, a monster which entices its victims with sweet music.”

Grassland leafhoppers (Hemiptera: Auchenorrhyncha) as indicators of habitat condition - a comparison of between-site and between-year differences in assemblage composition

The Auchenorrhyncha (leafhoppers) show great potential as indicators of grassland habitat quality, which would make them useful as a conservation tool. However, they are known to have labile populations. The relative importance of site identity and the year of sampling in the composition of leafhopper assemblages on chalk grassland are assessed for two sets of sites sampled twice. The study included a total of 95 sites (one set of 54, the other of 41), and demonstrated that for both sets the vegetation community and geographical location had high explanatory value, while the influence of year was small. The conclusion is that, notwithstanding population fluctuations, the leafhopper assemblages are a good indicator of habitat quality, and represent a potentially valuable tool in grassland conservation and restoration.

Toughness, the shearing of self-mated junctions and friction

Since ductile fracture (rupture) is the process by which junctions are separated and which prevents ever-increasing plasticity and junction growth, it is argued that models of friction ought to include toughness as well as yield strength. An expression for the coefficient of sliding friction is derived using ductile fracture mechanics. The predictions are quite reasonable.

What neuroimaging and perceptions of self-other similarity can tell us about the mechanism underlying mentalizing

Carruthers' "mindreading is prior" model postulates one unitary mindreading mechanism working identically for self and other. While we agree about shared mindreading mechanisms, there is also evidence from neuroimaging and mentalizing about dissimilar others that suggest factors that differentially affect self-versus-other mentalizing. Such dissociations suggest greater complexity than the mindreading is prior model allows.