Psychological interventions for alcohol misuse among people with co-occurring depression or anxiety disorders: A systematic review

Abstract OBJECTIVE: Depression, anxiety and alcohol misuse frequently co-occur. While there is an extensive literature reporting on the efficacy of psychological treatments that target depression, anxiety or alcohol misuse separately, less research has examined treatments that address these disorders when they co-occur. We conducted a systematic review to determine whether psychological interventions that target alcohol misuse among people with co-occurring depressive or anxiety disorders are effective. DATA SOURCES: We systematically searched the PubMed and PsychINFO databases from inception to March 2010. Individual searches in alcohol, depression and anxiety were conducted, and were limited to 'human' published 'randomized controlled trials' or 'sequential allocation' articles written in English. STUDY SELECTION: We identified randomized controlled trials that compared manual guided psychological interventions for alcohol misuse among individuals with depressive or anxiety disorders. Of 1540 articles identified, eight met inclusion criteria for the review. DATA EXTRACTION: From each study, we recorded alcohol and mental health outcomes, and other relevant clinical factors including age, gender ratio, follow-up length and drop-out rates. Quality of studies was also assessed. DATA SYNTHESIS: Motivational interviewing and cognitive-behavioral interventions were associated with significant reductions in alcohol consumption and depressive and/or anxiety symptoms. Although brief interventions were associated with significant improvements in both mental health and alcohol use variables, longer interventions produced even better outcomes. CONCLUSIONS: There is accumulating evidence for the effectiveness of motivational interviewing and cognitive behavior therapy for people with co-occurring alcohol and depressive or anxiety disorders.

Mediators of the relationship between person-organisation fit and individual outcomes

To date, research on P-O fit has focused heavily on the effect of P-O fit on individual and organisational outcomes. Few studies have attempted to explain how or why P-O fit leads to these outcomes. Meglino, Ravlin, and Adkins (1989) and Schein (1985) identified several intervening mechanisms for explaining fit-outcome relationships but only few of these explanations have been tested empirically (Cable & Edwards, 2004; Edwards & Cable, 2009; Kalliath, Bluedorn, & Strube, 1999). This thesis investigates role conflict, cognitive style and organisational justice as three potential mediating mechanisms in the relationship between P-O fit (defined as fit between personal and organisational values – value congruence or value fit) and outcomes including job satisfaction, job performance, service performance, affective commitment and continuance commitment. The study operationalised P-O fit using three measures: subjective fit, perceived fit and objective fit. The mediation model of subjective fit was tested using a Mplus analytical technique, while the mediation models of both perceived and objective fit were tested by modeling the difference between two scores (that is, between personal values and organisational values) using a polynomial regression and response surface analysis (Edwards, 1993). A survey of 558 mid-level managers from seven Brunei public sector organisations provided the data. Our results showed that the relationship between P-O fit and outcomes was partially mediated by organisational justice and cognitive style - for all the three measures of fit, while role conflict had no mediating effects. The findings from this research therefore have both theoretical and practical implications. This research contributes to the literature by combining these theoretical explanations for value congruence effects into one integrated model, and by providing evidence on the partial mediating effects of organisational justice and cognitive style. Future research needs to address and investigate other potential mechanisms by which value congruence affects individual and organisational outcomes. In addition, the study is considered to be the first to test these mediating roles for a value fit-outcomes relationship using three different measures of fit in a non-Western context.

The contribution of leadership attributes to large scale, complex project success

Mismanagement of large-scale, complex projects has resulted in spectacular failures, cost overruns, time blowouts, and stakeholder dissatisfaction. We focus discussion on the interaction of key management and leadership attributes which facilitate leaders’ adaptive behaviors. These behaviors should in turn influence adaptive team member behavior, stakeholder engagement and successful project outcomes, outputs and impacts. An understanding of this type of management will benefit from a perspective based in managerial and organizational cognition. The research question we explore is whether successful leaders of large-scale complex projects have an internal process leading to a display of administrative, adaptive, and enabling behaviors that foster adaptive processes and enabling behaviors within their teams and with external stakeholders. At the core of the model we propose interactions of key attributes, namely cognitive flexibility, affect, and emotional intelligence. The result of these cognitive-affective attribute interactions is leadership leading to enhanced likelihood of complex project success.

Address terms in turn beginnings: Managing disalignment and disaffiliation in telephone counselling

This paper examines use of address terms by counsellors on a telephone counselling service for children and young people. Drawing on conversation analytic findings and methods, we show how personal names are used in the management of structural and interpersonal aspects of counselling interaction. Focusing on address terms in turn-beginnings - where a name is used as, or as part of, a preface - the analysis shows that address terms are used in turns that are not fitted with prior talk in terms of either the activity or affective stance of the client. We discuss two environments in which this practice is observed: in beginning turns that initiate a new action sequence, and in turns that challenge the client’s position. Our focus is on the use of client names in the context of producing disaligning or disaffiliative actions. In disaligned actions, counsellors produced sequentially disjunctive turns that regularly involved a return to a counselling agenda. In disaffiliative actions counsellors presented a stance that did not fit with the affective stance of the client in the prior turn, for instance, in disagreeing with or complimenting the client. The paper discusses how such turns invoke a counselling agenda and how name use is used in the management of rapport and trust in counselling interaction.

University students’ depression : a cross-cultural investigation

Australian, Iranian and Portuguese university students (N = 967) completed University Students Depression Inventory (USDI; Khawaja & Bryden, 2006) in English, Persian, and Portuguese languages respectively. A series of MANOVA were used to examine differences in depression symptoms as an effect of the country and demographic variables. Interactions were also examined. The results indicated that country, gender, and year level had some impact on the depressive symptoms of the university students. Australian students were more depressed than the Iranian and Portuguese students, while Iranian students were more depressed than the Portuguese students. Subscales of USDI: Lethargy, Motivation, and Cognitive/Emotional were also used to compare the depressive symptoms of students. The Australian female students reported a significantly higher level of lethargy than their male counterparts. Similarly, the first year male students from Iran were significantly more lethargic than the first year Iranian female students. Iranian and Portuguese male students, compared to the female students of these countries, experienced a lower level of motivation. The Australian and Iranian students, compared to the Portuguese students, reported a significantly higher level of cognitive and affective symptoms. The scores on the Cognitive/Emotional subscale increased with the year level. Differences among students’ depression are described and implications discussed.

The subjective experience of negative symptoms : characteristics of emotional withdrawal

According to the diagnosis of schizophrenia in the DSM-IV-TR (American Psychiatric Association, 2000), negative symptoms are those personal characteristics that are thought to be reduced from normal functioning, while positive symptoms are aspects of functioning that exist as an excess or distortion of normal functioning. Negative symptoms are generally considered to be a core feature of people diagnosed with schizophrenia. However, negative symptoms are not always present in those diagnosed, and a diagnosis can be made with only negative or only positive symptoms, or with a combination of both. Negative symptoms include an observed loss of emotional expression (affective flattening), loss of motivation or self directedness (avolition), loss of speech (alogia), and also a loss of interests and pleasures (anhedonia). Positive symptoms include the perception of things that others do not perceive (hallucinations), and extraordinary explanations for ordinary events (delusions) (American Psychiatric Association, 2000). Both negative and positive symptoms are derived from watching the patient and thus do not consider the patient’s subjective experience. However, aspects of negative symptoms, such as observed affective flattening are highly contended. Within conventional psychiatry, the absence of emotional expression is assumed to coincide with an absence of emotional experience. Contrasting research findings suggests that patients who were observed to score low on displayed emotional expression, scored high on self ratings of emotional experience. Patients were also observed to be significantly lower on emotional expression when compared with others (Aghevli, Blanchard, & Horan, 2003; Selton, van der Bosch, & Sijben, 1998). It appears that there is little correlation between emotional experience and emotional expression in patients, and that observer ratings cannot help us to understand the subjective experience of the negative symptoms. This chapter will focus on research into the subjective experiences of negative symptoms. A framework for these experiences will be used from the qualitative research findings of the primary author (Le Lievre, 2010). In this study, the primary author found that subjective experiences of the negative symptoms belonged to one of the two phases of the illness experience; “transitioning into emotional shutdown” or “recovering from emotional shutdown”. This chapter will use the six themes from the phase of “transitioning into emotional shutdown”. This phase described the experience of turning the focus of attention away from the world and onto the self and the past, thus losing contact with the world and others (emotional shutdown). Transitioning into emotional shutdown involved; “not being acknowledged”, “relational confusion”, “not being expressive”, “reliving the past”, “detachment”, and “no sense of direction” (Le Lievre, 2010). Detail will be added to this framework of experience from other qualitative research in this area. We will now review the six themes that constitute a “transition into emotional shutdown” and corresponding previous research findings.

Modern construction economics [Book Review]

The editor, Gerard de Valence, points out in the preface, this book is neither a textbook nor a guide to what is done by construction managers and construction economists – read quantity surveyors and the like. Rather, de Valence notes it comprises a collection of chapters each of which focus on matters at the industry level and, in doing so, illustrates that a substantially improved understanding of the building and construction industry can be gained beyond the economics of delivering projects. Before giving some thought to how far each of the chapters achieve this, it’s worth reflecting on the virtues of developing construction economics as its own discipline or sub-discipline in general economics and the bold manner by which de Valence is proposing we do this. That is, de Valence proposes partitioning industry and project economics - as explained in the preface and in Chapter 1. de Valence’s view that “the time seems right” for these developments is also worthy of some consideration.

A multi-level model of leadership in complex project management

Management (or perceived mismanagement) of large-scale, complex projects poses special problems and often results in spectacular failures, cost overruns, time blowouts and stakeholder dissatisfaction. While traditional project management responds with increasingly administrative constraints, we argue that leaders of such projects also need to display adaptive and enabling behaviours to foster adaptive processes, such as opportunity recognition, which requires an interaction of cognitive and affective processes of individual, project, and team leader attributes and behaviours. At the core of this model we propose is an interaction of cognitive flexibility, affect and emotional intelligence. The result of this interaction is enhanced leader opportunity recognition that, in turn, facilitates multilevel outcomes.

Person-environment fit: project leader-stakeholder relationships in a complex project environment

In this paper, we develop a conceptual model to explore the perceived complementary congruence between complex project leaders and the demands of the complex project environment to understand how leaders’ affective and behavioural performance at work might be impacted by this fit. We propose that complex project leaders high in emotional intelligence and cognitive flexibility should report a higher level of fit between themselves and the complex project environment. This abilities-demands measure of fit should then relate to affective and behavioural performance outcomes, such that leaders who perceive a higher level of fit should establish and maintain more effective, higher quality project stakeholder relationships than leaders who perceive a lower level of fit.

The two faces of normative commitment : a qualitative study of the dual nature of normative commitment

Organisational commitment is extensively represented in the human resource management and organisational behaviour literature as a key factor in the relationship between employees and their organisations. Although Allen and Meyer (1990) noted that an employee can experience the three components of organisational commitment simultaneously, in terms of commitment profiles, the majority of studies have looked at the antecedents and outcomes of affective, continuance, and normative commitment independently. There is still only limited research that has investigated the nature of commitment profiles and their implications for employee work-related behaviours (Gellatly Meyer and Luchak 2006; Herscovitch & Meyer 2002; Somers 2010; Wasti 2005). An area where the commitment profiles approach potentially provides new insights is on the nature of normative commitment.

Seasonality of suicide in Shandong China, 1991–2009 : associations with gender, age, area and methods of suicide

Backgrounds Whether suicide in China has significant seasonal variations is unclear. The aim of this study is to examine the seasonality of suicide in Shandong China and to assess the associations of suicide seasonality with gender, residence, age and methods of suicide. Methods Three types of tests (Chi-square, Edwards' T and Roger's Log method) were used to detect the seasonality of the suicide data extracted from the official mortality data of Shandong Disease Surveillance Point (DSP) system. Peak/low ratios (PLRs) and 95% confidence intervals (CIs) were calculated to indicate the magnitude of seasonality. Results A statistically significant seasonality with a single peak in suicide rates in spring and early summer, and a dip in winter was observed, which remained relatively consistent over years. Regardless of gender, suicide seasonality was more pronounced in rural areas, younger age groups and for non-violent methods, in particular, self-poisoning by pesticide. Conclusions There are statistically significant seasonal variations of completed suicide for both men and women in Shandong, China. Differences exist between residence (urban/rural), age groups and suicide methods. Results appear to support a sociological explanation of suicide seasonality.

Understanding evaluation of learning support in mathematics and statistics

With rapid and continuing growth of learning support initiatives in mathematics and statistics found in many parts of the world, and with the likelihood that this trend will continue, there is a need to ensure that robust and coherent measures are in place to evaluate the effectiveness of these initiatives. The nature of learning support brings challenges for measurement and analysis of its effects. After briefly reviewing the purpose, rationale for, and extent of current provision, this article provides a framework for those working in learning support to think about how their efforts can be evaluated. It provides references and specific examples of how workers in this field are collecting, analysing and reporting their findings. The framework is used to structure evaluation in terms of usage of facilities, resources and services provided, and also in terms of improvements in performance of the students and staff who engage with them. Very recent developments have started to address the effects of learning support on the development of deeper approaches to learning, the affective domain and the development of communities of practice of both learners and teachers. This article intends to be a stimulus to those who work in mathematics and statistics support to gather even richer, more valuable, forms of data. It provides a 'toolkit' for those interested in evaluation of learning support and closes by referring to an on-line resource being developed to archive the growing body of evidence. © 2011 Taylor & Francis.

Associations between young children's emotion attributions and prediction of outcome in differing social situations

Associations between young children's attributions of emotion at different points in a story, and with regard to their own prediction about the story's outcome, were investigated using two hypothetical scenarios of social and emotional challenge (social entry and negative event). First grade children (N = 250) showed an understanding that emotions are tied to situational cues by varying the emotions they attributed both between and within scenarios. Furthermore, emotions attributed to the main protagonist at the beginning of the scenarios were differentially associated with children's prediction of a positive or negative outcome and with the valence of the emotion attributed at the end of the scenario. Gender differences in responses to some items were also found. © 2010 The British Psychological Society.

Electro-cortical implicit race bias does not vary with participants' race or sex

Earlier research found evidence for electro-cortical race bias towards black target faces in white American participants irrespective of the task relevance of race. The present study investigated whether an implicit race bias generalizes across cultural contexts and racial in- and out-groups. An Australian sample of 56 Chinese and Caucasian males and females completed four oddball tasks that required sex judgements for pictures of male and female Chinese and Caucasian posers. The nature of the background (across task) and of the deviant stimuli (within task) was fully counterbalanced. Event-related potentials (ERPs) to deviant stimuli recorded from three midline sites were quantified in terms of mean amplitude for four components: N1, P2, N2 and a late positive complex (LPC; 350–700 ms). Deviants that differed from the backgrounds in sex or race elicited enhanced LPC activity. These differences were not modulated by participant race or sex. The current results replicate earlier reports of effects of poser race relative to background race on the LPC component of the ERP waveform. In addition, they indicate that an implicit race bias occurs regardless of participant's or poser's race and is not confined to a particular cultural context.

A prospective study investigating the impact of school belonging factors on negative affect in adolescents

School belonging, measured as a unidimensional construct, is an important predictor of negative affective problems in adolescents, including depression and anxiety symptoms. A recent study found that one such measure, the Psychological Sense of School Membership (PSSM) scale, actually comprises three factors: Caring Relations, Acceptance, and Rejection. We explored the relations of these factors with negative affect in a sample of 504 Australian grade 7 and 8 students who completed the PSSM and Children’s Depression Inventory (CDI) at three time points. Each school belonging factor contributed to the prediction of negative affect in cross-sectional analyses. Scores on the Acceptance factor predicted subsequent negative affect for boys and girls, even controlling for prior negative affect. For girls, the Rejection factor was also significant in the prospective analysis. These findings have implications for the design of interventions and are further confirmation that school belonging should be considered a multidimensional construct.