Self-efficacy in Thought Control , not Positive Gains, Mediates Effect of Benefit-Finding Intervention for Carers

This study examines the therapeutic mechanism of the benefit-finding therapeutic (BFT) intervention that used cognitive reappraisal and alternative thinking to construct positive aspects of caregiving (PAC), in a cluster-randomized controlled trial for Alzheimer caregivers. 42 caregivers received BFT whereas 87 received psychoeducation as control. Both interventions were held in groups. Depressive symptoms and global burden were outcomes measured at baseline, postintervention, and 4- and 10-month follow-up. Mediators considered included PAC and three self-efficacies—controlling upsetting thoughts (SE-CUT), responding to disruptive behaviors, and obtaining respite. Using mixed-effects regression, we demonstrated that benefit-finding increased caregivers’ PAC and SE-CUT, but that only SE-CUT uniquely predicted depressive symptoms and global burden longitudinally. Path analyses with bootstrapped confidence intervals showed that SE-CUT change from baseline to postintervention mediated intervention effects on depressive symptoms, but not global burden, at both follow-ups. No mediation effects were found for PAC and the other self-efficacies. As a conclusion, The BFT effect on depressive symptoms was partly accounted for by improvement in SE-CUT. The therapeutic mechanism for the effect on burden remained unknown. The study sheds light on the importance of actively promoting positive caregiver functioning.

Active suppression prevents the return of threat memory in humans

Unbidden distressing memories inflict serious damage on mental health. Extant research highlights the importance of associative learning in modulating aversive memory. We report that conscious active suppression eliminates learned fear responses independent of memory triggers and is related to individual difference in thought control ability; in contrast, thought diversion only reduces cue-specific fear response. These results suggest potential avenues for treatment of persistent maladaptive memories by engaging declarative mnemonic control mechanisms.

375 Thought Control Strategies and Insomnia Severity in young-adult urban residing African Americans

Introduction Poor sleep is common in our society, particularly for African Americans. Unwanted, intrusive thoughts at bedtime contribute to sleep disturbances, and the nature of intrusive thoughts may be influenced by perception of threat among people living in stressful urban environments. Research has suggested that strategies to control intrusive thoughts vary in their adaptiveness and may be modifiable. These findings need to be confirmed in populations residing in stressful urban environments where perceived threats contribute to intrusive thoughts.The present study attempts to replicate prior research examining the relationship between thought control strategies and insomnia in urban residing young-adult African Americans. Methods Sixty-three young-adult African Americans completed the Thought Control Questionnaire for Insomnia-Revised and the Insomnia Severity Index (ISI). Results Thought control strategies previously associated with insomnia were significantly correlated with the ISI (aggressive suppression r=0.51, p<0.01 social avoidance r=0.32, p<.01, behavioral distraction r=0.386, p<0.01 and worry r=0.51, p<0.01). We did not find significant associations between the thought control strategy previously associated with healthy sleep and the ISI (cognitive distraction r= 0.20, p>0.05). In a grouped comparison between good sleepers and those with insomnia worry was the only subscale that was endorsed significantly greater among those with insomnia (t(61)=-2.91, p<.05) Conclusion These preliminary data replicate prior findings that suggest that aggressive suppression and worry are maladaptive thought control strategies. in a young-adult African American sample. Future research with a larger sample is needed to identify strategies that can improve sleep in this population. Support (if any) 5R01HL136626 from the National Heart Lung and Blood Institute

The Natural History of Insomnia: Predisposing, precipitating, coping and perpetuating factors over the early developmental course of insomnia

While there is an extensive literature on predisposing, precipitating, coping and perpetuating factors in those with chronic insomnia, very little work has been undertaken to evaluate these factors over the early developmental course of insomnia. The present aim was to determine whether several hypothesized factors in each domain (predisposing, precipitating, coping and perpetuating), assessed during an episode of acute insomnia, are related to its persistence or remission to normal sleep. Participants comprised n = 140 people with acute insomnia and n = 737 normal sleepers recruited from the general public. Participants completed measures assessing predisposing characteristics (personality traits, arousal predisposition and insomnia vulnerability), precipitating events and outcomes (life events, perceived stress, anxiety and depression), coping styles (thought control strategies and coping styles) and perpetuating factors (sleep preoccupation, pre-sleep arousal, dysfunctional beliefs and fatigue). Additionally, insomnia status (from acute insomnia at baseline to its persistence or natural remission) was assessed one month later (n = 129). Baseline differences between normal sleepers and individuals with acute insomnia were observed in each domain with increasing age, lower openness to experience and conscientiousness, higher insomnia severity, levels of anxiety and affective sleep preoccupation significantly predicting acute insomnia status. Further, a previous episode of insomnia, higher depression scores and affective sleep preoccupation scores significantly predicted its persistence, as opposed to its natural remission. Results are discussed with reference to the conceptualization of insomnia and how the findings may influence the design of preventative interventions to circumvent the transition from acute to chronic insomnia.