This study explored the effects of consistent and inconsistent combinations of paradoxical and nonparadoxical interpretations and directives in brief counseling with moderately depressed college students. We hypothesized that a consistent paradoxical intervention (paradoxical interpretations and directives) would be more effective than inconsistent interventions, which in turn would be more effective than a consistent nonparadoxical intervention. Forty-nine moderately depressed college students who wanted to change were randomly assigned to four interview intervention conditions and a no-treatment control condition. In the intervention conditions, students received two interviews with counselors who gave six interpretations and two directives over the course of the interviews. Students in the intervention conditions decreased their depression more than did students in the control condition. Paradoxical interpretations were associated with more symptom remission than were nonparadoxical interpretations, whereas the nature of the directives students received made little difference: Whether the interventions were consistent or inconsistent made little difference on changes in depression, but students had more favorable impressions of their counselors when interpretations and directives were consistent. The impact of the interventions on students' attributions of the cause of therapeutic change was also explored.
Strategies to link impulsivity and self-injurious behaviors (SIBs) show highly variable results, and may differ depending on the impulsivity measure used. To better understand this lack of consistency, we investigated correlations between self-report and behavioral impulsivity, inhibitory control, SIBs, and rumination. We included participants aged 13–17 years with either current or remitted psychopathology who have (n = 31) and who do not have (n = 14) a history of SIBs. Participants completed self-report measures of impulsivity, the Rumination Responsiveness Scale (RRS), and two behavioral measures of impulsivity: the Balloon Analogue Risk Task (BART) and Parametric Go/No-Go (PGNG). Lifetime SIBs were positively associated with self-reported impulsivity, specifically positive and negative urgency. However, individuals with greater lifetime SIBs demonstrated greater risk aversion (lower impulsivity) as measured by the BART, whereas there was no relation between lifetime SIBs and PGNG performance. There was no relation between rumination and behavioral impulsivity, although greater rumination was associated with higher negative urgency. Future research examining the role of SIBs in the context of active versus remitted psychopathology is warranted. Because most adolescents were remitted from major depressive disorder at the time of study, follow-up studies can determine if lower risk-taking may aid individuals with more prior SIBs to achieve and maintain a remitted state.
Introduction Rumination, or repetitive and habitual negative thinking, is associated with psychopathology and related behaviors in adolescents, including non‐suicidal self‐injury (NSSI). Despite the link between self‐reported rumination and NSSI, there is limited understanding of how rumination is represented at the neurobiological level among youth with NSSI. Method We collected neuroimaging and rumination data from 39 adolescents with current or past NSSI and remitted major depression. Participants completed a rumination induction fMRI task, consisting of both rumination and distraction blocks. We examined brain activation associated with total lifetime NSSI in the context of the rumination versus distraction contrast. Results Lifetime NSSI was associated with a greater discrepancy in activation during rumination relative to distraction conditions in clusters including the precuneus, posterior cingulate, superior, and middle frontal gyrus, and cerebellum. Conclusion Difficulties associated with rumination in adolescents with NSSI may be related to requiring greater cognitive effort to distract from ruminative content in addition to increased attention in the context of ruminative content. Increasing knowledge of neurobiological circuits and nodes associated with rumination and their relationship with NSSI may enable us to better tailor interventions that can facilitate lasting well‐being and neurobiological change.
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