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Four experiments were carried out to examine listener- and talker-related factors that may influence degree of perceived foreign accent. In each, native English listeners rated English sentences for degree of accent. It was found that degree of accent is influenced by range effects. The larger the proportion of native (or near-native) speakers included in a set of sentences being evaluated, the more strongly accented listeners judged sentences spoken by non-native speakers to be. Foreign accent ratings were not stable. Listeners judged a set of non-native-produced sentences to be more strongly accented after, as compared to before, they became familiar with those sentences. One talker-related effect noted in the study was the finding that adults' pronunciation of an L2 may improve over time. Late L2 learners who had lived in the United States for an average of 14.3 years received significantly higher scores than late learners who had resided in the United States for 0.7 years. Another talker-related effect pertained to the age of L2 learning (AOL). Native Spanish subjects with an AOL of five to six years were not found to have an accent (i.e., to receive significantly lower scores than native English speakers), whereas native Chinese subjects with an average AOL of 7.6 years did have a measurable accent. The paper concludes with the presentation of several hypotheses concerning the relationship between AOL and degree of foreign accent.

Background Digital mental health interventions offer unique advantages, and research indicates that these interventions are effective for a range of mental health concerns. Although these interventions are less established for individuals with serious mental illnesses, they demonstrate significant promise. A central consideration in traditional face-to-face therapies is the therapeutic alliance, whereas the nature of a digital therapeutic alliance and its relationship with outcomes requires further attention, particularly for individuals with serious mental illnesses. Objective This narrative review aims to encourage further consideration and critical evaluation of the therapeutic alliance in digital mental health, specifically for individuals with serious mental illnesses. Methods A narrative review was conducted by combining 3 main areas of the literature: the first examining the evidence for digital mental health interventions for serious mental illnesses, the second illuminating the nature and role of the therapeutic alliance in digital interventions, and the third surrounding practical considerations to enhance a digital therapeutic alliance. Results Results indicated that a therapeutic alliance can be cultivated in digital interventions for those with serious mental illnesses, but that it may have unique, yet-to-be-confirmed characteristics in digital contexts. In addition, a therapeutic alliance appears to be less directly associated with outcomes in digital interventions than with those in face-to-face therapies. One possibility is that the digital therapeutic alliance is associated with increased engagement and adherence to digital interventions, through which it appears to influence outcomes. A number of design and implementation considerations may enhance the digital therapeutic alliance, including human support and technological features. Conclusions More research is required to further understand the nature and specific role of a therapeutic alliance in digital interventions for serious mental illnesses, particularly in informing their design. This review revealed several key research priorities to advance the therapeutic alliance in digital interventions.

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BackgroundThe primary objective of this randomised controlled trial (RCT) is to establish the effectiveness of a novel online quality of life (QoL) intervention tailored for people with late stage (≥ 10 episodes) bipolar disorder (BD) compared with psychoeducation. Relative to early stage individuals, this late stage group may not benefit as much from existing psychosocial treatments. The intervention is a guided self-help, mindfulness based intervention (MBI) developed in consultation with consumers, designed specifically for web-based delivery, with email coaching support.Methods/designThis international RCT will involve a comparison of the effectiveness and cost-effectiveness of two 5-week adjunctive online self-management interventions: Mindfulness for Bipolar 2.0 and an active control (Psychoeducation for Bipolar). A total of 300 participants will be recruited primarily via social media channels. Main inclusion criteria are: a diagnosis of BD (confirmed via a phone-administered structured diagnostic interview), no current mood episode, history of 10 or more mood episodes, no current psychotic features or active suicidality, under the care of a medical practitioner. Block randomisation will be used for allocation to the interventions, and participants will retain access to the program for 6 months. Evaluations will be conducted at pre- and post- treatment, and at 3- and 6- months follow-up. The primary outcome measure will be the Brief Quality of Life in Bipolar Disorder Scale (Brief QoL.BD), collected immediately post-intervention at 5 weeks (T1). Secondary measures include BD-related symptoms (mania, depression, anxiety, stress), time to first relapse, functioning, sleep quality, social rhythm stability and resource use. Measurements will be collected online and via telephone assessments at baseline (T0), 5 weeks (T1), three months (T2) and six months (T3). Candidate moderators (diagnosis, anxiety or substance comorbidities, demographics and current treatments) will be investigated as will putative therapeutic mechanisms including mindfulness, emotion regulation and self-compassion. A cost-effectiveness analysis will be conducted. Acceptability and any unwanted events (including adverse treatment reactions) will be documented and explored.DiscussionThis definitive trial will test the effectiveness and cost-effectiveness of a novel QoL focused, mindfulness based, online guided self-help intervention for late stage BD, and investigate its putative mechanisms of therapeutic action.Trial registrationClinicalTrials.gov: NCT03197974. Registered 23 June 2017.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1805-9) contains supplementary material, which is available to authorized users.

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Differences in cognitive and coping style relationships with symptom expression across bipolar I and II disorder may provide clinicians with fruitful guides for directing treatment interventions when relevant maladaptive styles are observed. Further exploration of differences in cognitive and coping styles in bipolar I and II disorder is warranted.

Perfectionism has been associated with a rigid adherence to impossibly high standards, an irrational importance on the attainment of these standards, and a tendency to overgeneralize failures. Researchers have primarily focused on how perfectionism predicts psychological adjustment; yet, recent research also indicates that perfectionism impacts students' achievement motivation. In this article, research on the relationship between perfectionism and achievement motivation in non‐gifted students is reviewed. Conclusions about perfectionism and achievement motivation in non‐gifted students will highlight directions for future research and implications for enhancing the achievement motivation of gifted students with perfectionism. © 2012 Wiley Periodicals, Inc.