Relevant empirical studies and reviews from cross-cultural and cultural psychology, sociology, psychiatric epidemiology, mental health, management, linguistics, history, and anthropology literature were synthesized into three broad topics: culture of origin issues, common psychosocial challenges, and clinical recommendations.

Russian speakers probably differ in their form of collectivism, gender relations, emotion norms, social support, and parenting styles from what many clinicians are familiar with and exhibit an apparent paradoxical mix of modern and traditional values. While some immigrant groups from the Former Soviet Union are adjusting well, others have shown elevated levels of depression, somatization, and alcoholism, which can inform cultural adaptations.

Testable assessment and therapy adaptations for Russians were outlined based on integrating clinical and cultural psychology perspectives.

Database and hand-searches were made using search terms and eligibility criteria, yielding a total of 123 studies.

The review begins with what characterizes online counseling. Outcome and process research in online counseling is reviewed. Features and cyberbehaviors of online counseling such as anonymity and disinhibition, convenience, time-delay, the loss of social signaling, and writing behavior in cyberspace are discussed. Ethical behavior, professional training, client suitability, and clients’ and therapists’ attitudes and experiences of online counseling are reviewed.

A growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face-to-face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables.

The present study randomized 40 combat veterans (mean age 37.7 years; 90% male and 60% African American) who served in Afghanistan and/or Iraq (Operation Enduring Freedom [OEF] / Operation Iraqi Freedom [OIF]) to 4 sessions of CBT-I with adjunctive IRT or a waitlist control group. Two thirds of participants had nightmares at least once per week and received the optional IRT module.

At posttreatment, veterans who participated in CBT-I/IRT reported improved subjectively and objectively measured sleep, a reduction in PTSD symptom severity and PTSD-related nighttime symptoms, and a reduction in depression and distressed mood compared to the waitlist control group.

The findings from this first controlled study with OEF/OIF veterans suggest that CBT-I combined with adjunctive IRT may hold promise for reducing both insomnia and PTSD symptoms. Given the fact that only half of the patients with nightmares fully implemented the brief IRT protocol, future studies should determine if this supplement adds differential efficacy to CBT-I alone.

Participants (N = 651) completed a survey on demographic characteristics, coping strategies, and psychosocial outcomes (negative life events, alcohol consumption, drinking problems, and suicidal ideation).

At the follow-up (N = 521), more use of avoidance coping was associated with more drinking problems and suicidal ideation at follow-up. Men high in avoidance coping reported more alcohol consumption and suicidal ideation at follow-up than did men low on avoidance coping. Younger adults high in avoidance coping reported more negative life events at follow-up than did younger adults low on avoidance coping.

Reliance on avoidance coping may be especially problematic among men and younger adults.

Nonparametric bootstrapping procedures were used to examine theoretical relationships among variables in a psychiatric sample of adults (N = 70). Participants were asked to imagine themselves in distress-inducing situations and then write what they would actually do to decrease distress in such situations.

As hypothesized, mindfulness statistically mediated the relationship of BPD features to reported acts of (a) self-injury and (b) overall harmful dysregulated behaviors.

Difficulties in the ability to be aware, attentive, and accepting of ongoing experience may play a role in the relationship of BPD features to harmful dysregulated behaviors. Future research should clarify potential reciprocal effects between BPD features and mindfulness with prospective, multioccasion designs.

Women (N = 42, M_age = 34) with BPD, PTSD and recent intentional self-injury were evaluated upon entry into a psychotherapy outcome study.

The majority preferred a combined dialectical behavior therapy (DBT) and prolonged exposure (PE) treatment (73.8%), followed by DBT alone (26.2%), and PE alone (0%). Women who preferred the combined treatment were more likely to report a desire to obtain relief from PTSD and to receive specific DBT and PE treatment components as reasons underlying this preference. Few women (21.4%) reported concerns about PE, but those who did were more likely to prefer DBT alone. More severe PTSD re-experiencing symptoms, a childhood index trauma, and less reduction in positive affect after a trauma interview predicted a preference for the combined treatment.

These results may help to inform treatment for these complex patients.

Preexisting records of a sample of male alcohol- and opioid-dependent treatment seeking adults (N = 97; mean age = 42.55) were reviewed for the current study.

Pre-post analyses demonstrated that 8 of the early maladaptive schemas significantly decreased by the end of the 4-week treatment.

Findings indicate that early maladaptive schemas can be modified during brief substance use treatment and may be an important component of substance use intervention programs. Implications of these findings for substance use treatment are discussed.

Three hundred and twenty-nine adults from across the United States (60.2% female, mean age = 35.92) each rated their attitudes toward seeking two varieties of psychotherapy: one emphasizing nonspecific common factors, and one emphasizing specific evidence-based therapy ingredients.

Analyses revealed a pronounced preference for therapy guided by common factors among clients and nonclients alike, even when controlling for a host of individual difference variables.

These data conceptually replicate Swift and Callahan's findings and indicate that potential clients may seek help more readily from providers who accentuate the nonspecific aspects of therapy.

Experience sampling methods were used to monitor thoughts, emotions, and behaviors in 47 individuals reporting dysregulated behaviors including NSSI. Instability indices were generated for rumination and negative emotion using the momentary assessments.

Twenty-five episodes of NSSI were reported during monitoring. Trait rumination prospectively predicted NSSI episodes, and the instability indices interacted to predict NSSI.

Consistent with the ECM, the interaction between rumination instability and negative affect instability during monitoring significantly predicted NSSI, with the strongest effects occurring for sadness and rumination about past. These findings may enhance conceptualization and treatment of patients with NSSI.

Multilevel modeling procedures were used to examine longitudinal Youth Outcome Questionnaire (YOQ) data for 16,091 youth aged 4-17 years (39% female, mean age 10.5) referred for treatment in a managed care system.

Clients with more frequent YOQ administrations had slightly lower baselines and faster rates of change. Both the traditional and simplified versions of the early warning system demonstrated good accuracy in identifying clients who deteriorated, with a sensitivity of .63, specificity of .83, and hit rate of .81.

Results provide further evidence that patient-focused early warning systems can accurately identify most youth who are at risk for negative outcomes in routine mental health services.

We begin with a review of the literature on OSA and comorbid insomnia. We then present a multidisciplinary approach using pulmonary and behavioral sleep medicine treatments.

OSA and insomnia co-occur at a high rate and such patients have distinct clinical features. Empirically supported treatments are available for OSA and insomnia independently but there are no standards or guidelines for how to implement these treatments for patients who suffer from both disorders.

Multidisciplinary treatment holds promise for patients with comorbid sleep disorders. Further research should be aimed at optimizing treatments and developing standards of practice for this population.

Undergraduate student women reporting elevated spider fear (N = 33, Age mean = 18.88) were recruited for this study. Participants completed self-report measures of spider fear and dispositional courage. They then completed either a courage or neutral word search prime, which was followed by a behavioral approach task involving a tarantula.

Consistent with predictions, among those reporting lower dispositional courage, the courage prime led to reduced approach behavior relative to the neutral prime. However, no group differences were found among those high in dispositional courage.

These findings point to the importance of self-perceptions in moderating the effects of behavioral primes and suggest limitations to the use of such interventions with individuals with psychological dysfunction.

Clients (N = 102) at two sites were randomly assigned to one of three alliance feedback conditions: (a) IF—SRS completed in presence of therapist and the results discussed immediately afterward; (b) Next Session Feedback—SRS completed alone and results discussed next session; or (c) No Feedback—SRS completed alone and results not available to therapist. Clients completed the SRS for the first three sessions of treatment.

No statistically significant differences in SRS scores across the feedback conditions were found. Additionally, the analysis showed that SRS scores were not correlated with a measure of social desirability but were correlated with an established alliance measure.

The results indicate that alliance scores were not inflated due to the presence of a therapist or knowing that the scores would be observed by the therapist.

Pre-treatment and post-treatment self-report measures of sleep were compared with those obtained from home-based polysomnography (PSG) in 60 adults (mean age = 69.17; 42 women) with comorbid insomnia. The self-report data were published previously in a randomized controlled trial demonstrating the efficacy of CBT-I compared with a placebo treatment.

Self-report measures significantly underestimated sleep at pre-treatment and CBT-I led to a correction in this discrepancy. There were no significant changes in PSG after CBT-I. Path analysis showed that an increase in an objective proxy measure of sleep quality (i.e., decreased stage N1 sleep) after CBT-I was significantly related to improvements in self-report of sleep, with full mediation by reductions in discrepancy.

This is the first CBT-I outcome study to analyze discrepancy changes and demonstrate that these changes account for a significant portion of self-report outcome. In addition, improved sleep quality as measured by a decrease in percentage of stage N1 sleep following treatment may be one mechanism that explains why sleep estimation is more accurate following CBT-I.

Using the MST, participants described a story from an emotionally challenging image and responded to a set of items about their cognitive and emotional processes while completing the task. The validation of the French version of the MST comprises two samples: 264 undergraduate/graduate students with a mean age of 27.27 years (Sample 1), and 206 students with a mean age of 26.61 years (Sample 2). The validation of the English version of the MST also includes two samples: 110 undergraduate students with a mean age of 20.15 years (Sample 3) and 188 students with a mean age of 20.90 years (Sample 4).

Results suggest that 6 mental states can be distinguished and that the MST presents an adequate factorial structure, in both its French and English versions. The MST scores were associated with mental state scores derived from a content analysis method and with other related constructs (e.g., authenticity, empathy).

Overall, findings provide convincing evidence of validity and reliability for the MST as an assessment tool of mental states. This innovative measure is likely to facilitate the clinical and empirical investigation of mentalization.

Participants (N = 56) completed two laboratory sessions to determine subjective and objective responses to a controlled laboratory stressor versus a control task. Baseline measures included drug use and smoking histories and a self-report measure of habitual stress (i.e., daily hassles). They were re-contacted 1 year after the laboratory sessions to determine smoking status.

There was wide variability in smoking trajectories, with 34% of participants increasing their smoking over the course of the year. Contrary to predictions, neither daily hassles nor stress reactivity was related to smoking at baseline or change over the year.

These preliminary findings suggest that daily stress or responses to acute social stress are not strong predictors of progression in emerging adult smokers.

The design of this research is cross-sectional and multicentered.

We used self-report questionnaires, factor analysis, and regression analysis.

We found evidence for a significant role of autonomy-connectedness in Axis I Psychopathology. This was especially true for women, who were found to be more sensitive to others and sensitivity to others was strongly associated with Axis I Psychopathology. Maybe due to the research sample no evidence was found for an association of autonomy-connectedness with externalizing psychopathology. As to the role of autonomy-connectedness in internalizing psychopathology, we found that a lack of self-awareness or a capacity of managing new situations, combined with a high sensitivity to others, were associated with internalizing psychopathology. Women appeared to be more sensitive to others and to report higher levels of Axis I Psychopathology than men.

We conclude that autonomy-connectedness plays an important role in Axis I Psychopathology as well as in internalizing Axis II pathology. Treatment of Axis I and internalizing Axis II psychopathology should therefore also focus on autonomy problems.

Participants were 155 female and 134 male undergraduates—mean age of 19.03 years. Participants completed measures of stability in the family of origin (Stability of Activities in the Family Environment), self-control (Self-Control scale), current externalizing (Adult Self-Report), and internalizing problems (Beck Depression Inventory II and Beck Anxiety Inventory).

Multiple regression analyses largely support the proposed model for both the externalizing and internalizing domains.

Family stability may foster the development of self-control and, in turn, lead to positive adjustment.

Two samples of survivors of interpersonal trauma were included: undergraduates (n = 290, 60% female) and intimate partner violence survivors from the community (n = 114). Participants completed self-report measures that assessed psychopathology, emotion dysregulation, attachment processes, and cognitions about the world, self, and others.

Emotion dysregulation was strongly linked to symptoms of depression, posttraumatic stress disorder, and somatization in both samples. Cognitions also accounted for unique variance in predicting symptoms of depression and somatization in both samples.

Results suggest that disruption in the ability to regulate emotions is the most consistent predictor of mental health in survivors of interpersonal trauma, followed by cognitions regarding the world, self, and others. Treatment implications are discussed.

The present study randomly assigned 30 psychiatric outpatients (mean duration of treatment = 3.6 years) with low sleep quality and residual depressive symptoms to two sessions of CBT-I or a treatment as usual control group. Assessment included the Pittsburgh Sleep Quality Index (PSQI) for insomnia and the Patient Health Questionnaire (PHQ-9) for depression at pretreatment and 4 and 8 weeks posttreatment.

Patients who received CBT-I demonstrated within group changes in PSQI and the PHQ-9 scores at both 4 and 8 weeks posttreatment, but did not show between-group differences. Additionally, 38% of the treatment participants achieved normal sleep at follow-up compared with none in the control condition.

This study provides preliminary evidence that abbreviated behavioral treatment has beneficial effects on residual insomnia and depression in long-term psychiatric outpatients.

N = 50 outpatients presenting with various psychiatric disorders and undergoing 4 sessions of Brief Psychodynamic Intervention (BPI; Despland, Drapeau, & de Roten, 2005; Despland, Michel, & de Roten, 2010) were included in this naturalistic study (mean age: 31 years; 56% female; all Caucasian). Cognitive errors and coping strategies were assessed using the Cognitive Errors Rating Scale (Drapeau et al., 2008) and Coping Patterns Rating Scale (Perry et al., 2005). These observer rated methods were applied to the verbatim transcriptions of all 4 therapy sessions completed by each patient.

Results indicate change in both cognitive errors and coping patterns over the course of BPI, including an increase in the Overall Coping Functioning and a decrease in unhelpful coping processes, such as isolation, which reflects a shift in participant appraisal towards stress appraised as a challenge at the end of treatment. These changes predicted symptom change at the end of treatment. While cognitive errors also changed over the course of BPI, no predictive effect was found with regard to symptom change.

These results are interpreted within the framework of common change principles in psychotherapy. Implications and future research are discussed.

Participants were 83 male and 3 female veterans with type 2 diabetes (M_age = 62.4). Self-report measures were completed during the baseline assessment of a larger intervention study conducted at the VA Boston Healthcare System.

Depression symptoms, anxiety symptoms, and sleep quality were all associated with DQOL. Additionally, sleep quality had a partial indirect effect on the relationships between depression symptoms and DQOL, and between anxiety symptoms and DQOL.

These findings suggest that sleep quality may have an important role in the way that psychological distress affects diabetes quality of life. © 2012 Wiley Periodicals, Inc. J. Clin. Psychol. 00:1-11, 2012.

Participants were 2,774 first-generation and second-generation immigrant students (70% women), from 6 ethnic groups and from 30 colleges and universities around the United States. Participants completed measures of heritage and American cultural practices, values, and identifications, as well as of subjective, psychological, and eudaimonic well-being.

Findings indicated that individualistic values were positively related to psychological and eudaimonic well-being, and positively, although somewhat less strongly, linked with subjective well-being. American and heritage identifications were both modestly related to psychological and eudaimonic well-being. These findings were consistent across gender, immigrant generation (first versus second), and ethnicity.

Psychological and eudaimonic well-being appear to be inherently individualistic conceptions of happiness, and endorsement of individualistic values appears linked with these forms of well-being. Attachments to a cultural group—the United States, one's country of origin, or both—appear to promote psychological and eudaimonic well-being as well. The present findings suggest that similar strategies can be used to promote well-being for both male and female students, for students from various ethnic backgrounds, and for both first-generation and second-generation immigrant students. © 2012 Wiley Periodicals, Inc. J. Clin. Psychol. 00:1–21, 2012.

The authors present an overview of MLM and growth curve analysis as applied to psychotherapy outcome. Results from a simulated data set illustrate how MLM-specifically, growth curve analysis–can be used to test hypotheses from randomized clinical trials.

Growth curve analyses were applied to simulated data from an experimental design (treatment versus control group) with multiple assessments of client distress and a client individual difference variable. Results of growth curve analyses confirmed what was found with a pretreatment/posttreatment repeated-measures ANOVA but provided additional information not available from the ANOVA framework.

Given its flexibility, MLM is the recommended method to assess patterns of change in studies of psychotherapy outcome.

Participants included 207 young adults who identified as lesbian/gay, bisexual, or questioning (50.2% female) and a heterosexual comparison group.

A hierarchical logistic regression showed that bisexual and questioning individuals were more likely to report having engaged in NSSI in their lifetime. A chi-square yielded no difference between groups on frequency of NSSI. Multivariate analyses of variance examining maladaptive and adaptive coping strategies demonstrated that bisexual and questioning individuals reported greater use of maladaptive strategies than the heterosexual group; however, there was little difference between groups on adaptive coping.

The relationship between sexual orientation and coping appears to be a complex one, suggesting that bisexual and questioning individuals attempt to use a wide range of coping mechanisms, possibly due to increased stress.

We used a cross-sectional design. The variables were selected to indicate key constructs of the three major forms of therapy considered. Study 1 used a sample of 152 students, who were assessed during a stressful period of their semester (mean age = 21.71; 118 females), while Study 2 used a clinical sample of 28 patients with generalized anxiety disorder (mean age = 26.67; 26 females).

Results showed that these constructs, central in the therapies considered, had medium to high associations to each other and to distress. Experiential avoidance was found to mediate the relationship between the other, schema-type cognitive constructs and emotional distress. Moreover, multiple mediation analysis in Study 2 seemed to indicate that the influence of the more general constructs on distress was mediated by experiential avoidance, whose effect seemed to be carried on further by automatic thoughts that were the most proximal to distress.

Although each of the cognitive constructs considered comes with its underlying theory, the relationships between them can no longer be ignored and cognitive behavioral therapy theoretical models reliably accounting for these relationships should be proposed and tested.

Emerging adults with mothers with mental illness (n = 52) and emerging adults without mothers with mental illness (n = 64) were recruited from institutes of higher education and responded to an online self-report questionnaire. Most participants (81%) were female.

Results from multiple mediation analyses indicated a history of parent-child role reversal mediated the association between having a mother with mental illness and emerging adults’ psychological symptoms. None of the assessed aspects of the emerging adult-mother relationship mediated the association between maternal mental illness and emerging adults’ psychological well-being, but having divorced parents and being older was associated with lower levels of psychological well-being.

Findings indicate role reversal contributes to emerging adults’ psychological symptoms. Assessment of a history of role reversal may be relevant to clinical practice with emerging adults, particularly those with mothers with mental illness. Life course perspectives can inform future studies of emerging adults with mothers with mental illness.

Data from N = 292 patients (75% female, mean age 36 years) with panic disorder and agoraphobia and treated with standardized CBT were analyzed with homework compliance quality and quantity for different types of homework serving as predictors for different outcome variables.

Quality ratings of homework completion were stronger outcome predictors than quantitative compliance ratings. Exposure homework was a better outcome predictor than homework relating to psychoeducation and self-monitoring.

Different aspects of homework compliance and specific homework types might differentially relate to CBT outcome.

This study aimed to examine IU across diagnostic categories, change in IU during transdiagnostic treatment, and the relationship between change in IU and treatment outcome.

Patients diagnosed with heterogeneous anxiety and depressive disorders received up to 18 weeks of a transdiagnostic cognitive-behavioral therapy intervention. Patient self-reported IU and self-report and clinician-rated symptom/functioning measures were administered at pretreatment and posttreatment.

When controlling for negative affectivity, IU correlated with measures of depressive symptoms and worry severity at pretreatment. Patients with GAD and panic disorder exhibited the highest pretreatment IU scores, yet IU scores did not differ significantly based on the presence or absence of a specific diagnosis. A significant decrease in IU was observed, and change in IU was related to reduced anxiety and depressive symptom levels at posttreatment across diagnostic categories.

Change in IU can be observed across problem areas in transdiagnostic treatment and such change is correlated with treatment outcome.

A sample of 50 treatment-receiving adults aged 21 to 67 years with a mix of common mental health difficulties was recruited from a clinical psychology service. Participants were given questionnaire measures of shame states, shame coping styles, intimate relationship functioning, and the therapeutic alliance.

Regression analyses indicated that the shame coping strategy of physical and psychological withdrawal was the primary risk factor for development of a less effective therapeutic alliance. Both withdrawal and attack self coping styles were significant predictors of impaired intimate relationship functioning.

These findings have implications for the theoretical role of shame in mental health presentations as well as the potential for internalizing shame coping styles (i.e., withdrawal, attack self) to act as a barrier to successful therapy and interpersonal relationships. The inclusion of shame-focused assessments and interventions in the initial stages of treatment with clients exhibiting these strategies could improve prognosis.

In a repeated measures design, PTSD symptoms, depression symptoms, social support, and weight were assessed in obese participants during 16 weeks at a weight loss facility.

The participants’ body mass index decreased significantly, and concurrently, a significant decline in the level of PTSD symptoms and depression symptoms was observed.

The beneficial effects of weight loss on depression are consistent with previous work. The decline in the level of PTSD symptoms simultaneously with weight loss is an important and positive effect that has not been reported previously.