Symptom distress and disability: Different sides of the same coin? An investigation of the relationship between symptom distress and disability over time in patients receiving treatment for internalizing disorders.

BACKGROUND: Most psychotherapy outcome research focuses on symptom reduction as a primary outcome. However, most patients do not seek psychological treatment exclusively for symptom relief, but mainly because they can no longer do what they want to do or used to do. Therefore, besides symptom reduction, also disability in daily functioning should be a focus of psychotherapy outcome research. Yet, until now there is a paucity in research pertaining to the relation between symptom reduction and reduction of disability during psychological treatment. AIMS: For this reason, the aim of the current study was to examine the relationship between changes in symptom reduction (reduction in general symptom distress) and changes in self-reported disability over a period of two years in patients that receive psychotherapy for mood and anxiety disorders (N = 1182). RESULTS: We found strong correlations between both outcome measures at all measurement points. Furthermore, results demonstrated a decrease in both outcome measures from start to end of treatment with a moderate effect for symptom distress and a small effect for experienced disability. Cross-lagged panel analysis demonstrated that a decrease in symptom distress predicted a subsequent decrease in self-reported disability, and a decrease in self-reported disability equally predicted a subsequent decrease in experienced symptom distress. CONCLUSION: Our results seem to indicate that both outcome measures are interchangeable in psychotherapy outcome studies for internalizing disorders.

Global perceptions of state apologies for human rights violations.

State apologies for human rights violations are often seen as a key mechanism in reconciliation processes. Nevertheless, they are often contested as well and have not been embraced equally by countries around the world. This raises questions about their universal value and potential to address or redress past harmdoing by countries. In a study across 33 countries (n = 11,023), we found that people around the world consider apologies by states for human rights violations to be reasonably important but tend to be less supportive of the idea that their own country should apologize for past harmdoing. We found that this discrepancy was amplified in countries with stronger honour norms and a stronger collective sense of victim- rather than perpetratorhood. Moving beyond the decontextualized approach that has prevailed in previous psychological research on this topic, our findings show that people's attitudes towards apologies by their country do not exist in a cultural and social vacuum but depend on the extent to which the broader context affords a critical reflection on past harmdoing. As such, they help explain why some countries have been reluctant to offer apologies, and why such gestures may also be more controversial in some contexts than in others.

Group-based shame, guilt, and regret across cultures.

To date, there has been no systematic examination of cross-cultural differences in group-based shame, guilt, and regret following wrongdoing. Using a community sample (N = 1358), we examined people's reported experiences of shame, guilt, and regret following transgressions by themselves and by different identity groups (i.e., family, community, country) in Burkina Faso, Costa Rica, Indonesia, Japan, Jordan, the Netherlands, Poland, and the United States. We assessed whether any variation in this regard can be explained by the relative endorsement of individualistic or collectivistic values at the individual level and at the country level. Our findings suggest that people's reported experience of these emotions mostly depends on the transgression level. We also observe some variation across individuals and countries, which can be partially explained by the endorsement of collectivistic and individualistic values. The results highlight the importance of taking into account individual and cultural values when studying group-based emotions, as well as the identity groups involved in the transgression.