This set of five papers documents, in part, our mixed viewpoints on depression.  Worryingly, Mehta & colleagues show deteriorating public attitudes towards mental illness in England (and to a lesser extent Scotland) between 1994 and 2003.  Meanwhile Blumner et al demonstrate a shift towards a more biological view on causes and treatment of depression in the US between 1996 and 2006.

In contrast, Miranda et al's editorial (and Grote et al's research) highlight the growing evidence showing psychotherapies for depression can be "very effective for low-income and minority populations in the United States and abroad" - extending their validity well beyond more privileged groups in developed countries.  Andersson too discusses a further way to make psychotherapies more widely available and helpful - in this case, the increasing literature documenting the widespread value of delivering cognitive behavioural therapy via the internet.     

I wrote a post yesterday introducing some of the ideas and research on implementation intentions.  Today I extend this in more practical how-to-do-it directions:

what are implementation intentions?
"Goal intentions" involve aiming for some desired future outcome.  They are of the form "I intend to attain goal X".  Unfortunately we know only too well that making such intentions does not necessarily mean that we will reach our goals.  As the old saying goes "There's many a slip between cup and lip".  A major review of 422 relevant research studies found that goal intentions accounted for only an average 28% of the variance in achievement of successful outcome (Sheeran, 2002).  Subsequent research suggests that even this figure of 28% is an overestimate (Webb and Sheeran, 2006).  The conclusion is clear - forming a strong goal intention to achieve some desired outcome in no way guarantees success. 

Here are five papers on difficulties experienced by adolescents.  A couple of the papers are follow-up studies.  Colman et al looked at the multiple negative personal & relationship outcomes in a UK national cohort of adolescents with conduct problems followed over 40 years.  Wentz et al studied the somewhat more encouraging 18 year outcomes of a group of adolescents suffering from anorexia. 

A couple of the papers are about depression.  Kennard and colleagues report again on the well-known Treatment for Adolescents with Depression Study (TADS) comparing antidepressants, cognitive-behavioural therapy and combined treatment.  By about six months there was little difference between the three forms of treatment.  At nine months the remission rate for intent-to-treat cases was 60% overall.  Primack et al investigated the association between electronic media use in adolescence and subsequent depression in young adulthood.  They reported "Controlling for all covariates including baseline Center for Epidemiologic Studies-Depression Scale score, those reporting more television use had significantly greater odds of developing depression."

Here are a few handouts that I've put together over the years to provide background information about depression.  The development & maintenance diagram is probably the handout here that I use most - both to explain issues about depression and also for many other psychological disorders as well. 

Development & maintenance of distressed states - I use this Powerpoint diagram a lot when discussing with people why they are in a distressed state.  The diagram applies to depression but it also applies to nearly all other distressed psychological states as well.  It can be helpful in highlighting the importance of maintaining, precipitating and vulnerability factors.  I also point out that therapeutic gains can be made working with all three of these general sets of factors - for example, emotional processing work for past experience (both precipitating and vulnerability factors) and more standard cognitive-behavioural approaches for maintaining factors. 

Here are half a dozen papers with anxiety relevance.  The first couple are about the interaction between genetic vulnerability (or resilience) and childhood experience.  The Stevens et al paper is an update on the large body of research looking at psychological genetic vulnerability/resilience in macaque monkeys and how this interacts with parenting quality to lead, or not lead, to emotional and neurophysiological disturbances in adulthood.  The Battaglia paper particularises this gene/environment investigation by looking at the connections between early human childhood separation anxiety, loss of a parent, and panic disorder in adulthood.  

Yesterday NICE - the National Institute for Health and Clinical Excellence in England & Wales - published guidance on a diverse range of fifteen clinical, technology, interventional and public health subjects.  Their clinical guidance on Medicines Adherence  interested me, as too did their public health guidance on Promoting Physical Activity for Children and Young People.  The subject of this post is the clinical guidance on Antisocial Personality Disorder and in my next post, I'll talk about their guidance on Borderline Personality Disorder.  As Dr Tim Kendall, Joint Director, National Collaborating Centre for Mental Health, states: "Approximately 2 million people in the UK have personality disorders, with antisocial and borderline disorders being the most common.

In blog postings earlier this month, I've talked about supporting my Mum after her recent couple of strokes.  She's been shipped through three different hospitals and now is more peaceful in a nursing home.  It's sad - very sad at times - and it's great that she seems more comfortable, better looked after, and more content.  I definitely feel easier too.  Less weight on my shoulders, less emotional aching.

Here are half a dozen papers relevant to psychotherapy.   The first two throw some light on the question of whether it matters which form of established psychotherapy one uses to treat a particular depression sufferer - bearing in mind Cuijpers et al's recent meta-analysis suggesting that " ...