Conducting psychotherapy around the globe: orientation and introduction.

Psychology has become a worldwide science and profession. A number of international associations sponsor meetings and draw together psychologists from around the globe. Psychology and psychotherapy also vary considerably from country to country. Educational systems, licensing patterns, and practice parameters differ in different health service delivery systems depending on the history and policies of the particular country. This issue contains invited articles by psychologists, from a wide sample of countries, who describe the nature of psychotherapy practice in their respective countries and its application to the hypothetical case of Mrs. A. The authors place the case in the cultural context Mrs. A might encounter in their country.

Psychotherapy in Iran: a case study of cognitive-behavioral family therapy for Mrs. A.

Family plays a significant role in the development and maintenance of depression. It has also been shown that cognitive-behavioral therapy (CBT) can be effective in treating depression. The prominent role of family in Iranian culture makes the application of CBT in family context preferable. In this article, we describe the evolution of psychotherapy in Iran and illustrate it through a case of CBT family therapy for Mrs. A.

A randomized trial of self-management and psychoeducational group therapies for comorbid chronic posttraumatic stress disorder and depressive disorder.

The authors randomized 101 male veterans with chronic combat-related posttraumatic stress disorder (PTSD) and depressive disorder to an evidence-based depression treatment (self-management therapy; n = 51) or active-control therapy (n = 50). Main outcome measures for efficacy, using intention-to-treat analyses, were subjective and objective PTSD and depression scales at pretest, posttest, and 3-, 6-, and 12-month follow-up. Other measures included treatment compliance, satisfaction, treatment-targeted constructs, functioning, service utilization, and costs. Self-management therapy's modestly greater improvement on depression symptoms at treatment completion disappeared on follow-up. No other differences on symptoms or functioning appeared, although psychiatric outpatient utilization and overall outpatient costs were lower with self-management therapy. Despite success in other depressed populations, self-management therapy produced no clinically significant effect in depression with chronic PTSD.

Depression, implicit memory, and self: a revised memory model of emotion.

Cognitive constructs are explored for clinical psychologists interested in cognitive phenomena in depression. Both traditional and modern memory constructs are outlined and described with attention to their contribution to understanding depression. In particular, the notions of memory construction, self-schemas, and autobiographical memory (per [Conway, M.A. (2001). Sensory-perceptual episodic memory and its context: Autobiographical memory. Philosophical Transactions of the Royal Society of London: Biological Sciences, 356, 1375-1384.]) are discussed. Then, the phenomenon of implicit memory is described as a way to bring these constructs together to understand depression. The Rehm and Naus (1990) [Rehm, L.P., and Naus, M.J. (1990). A memory model of emotion. In Ingram, R.E. (Ed.), Contemporary Psychological Approaches to Depression (pp. 23-35). New York: Plenum Press.] memory model of emotion is updated and expanded to include these cognitive constructs, and depression is viewed from the perspective of understanding interactions between explicit and implicit memory processes.

The empirical status of melancholia: implications for psychology.

The concept of a subtype of depression with a biological rather than a psychological set of causes has been more prominent in the psychiatric literature than in the psychological literature on depression. There has been dispute as to whether research on melancholia supports the distinction of a separate subtype with a distinct symptomatic profile characterized by marked anhedonia, psychomotor difficulties, excessive guilt or hopelessness, suicidal features, and appetite and weight disturbances. Research suggests that individuals with melancholic depression are qualitatively different from those with non-melancholic depression in their symptomatology. Examination of biological functioning, personality traits, responsiveness to treatment, and suicidality also tend to support the melancholic-non-melancholic distinction. This paper reviews the status of the melancholia concept and explores its implications for psychological research and practice.

Personality disorders in veterans with posttraumatic stress disorder and depression.

Little is known about the frequency of the full-range of personality disorders in outpatients with concurrent posttraumatic stress disorder (PTSD) and depression, a common and oftentimes treatment-resistant combination in clinical practice. In a group therapy outcome study, Axis I and II diagnoses were assessed with the Structured Clinical Interview for DSM-IV and the Clinician-Administered PTSD Scale to select 115 male combat veterans with PTSD and depressive disorder. Within this sample, 52 (45.2%) had one or more personality disorders--most commonly paranoid (17.4%), obsessive-compulsive (16.5%), avoidant (12.2%), and borderline (8.7%)--and 19 (16.5%) had two or more. Documenting a substantial frequency of personality disorders is a first step in devising appropriate interventions for this treatment-resistant combination of disorders.