Case Report—Loyalty, Legacy, and Ledger: Contextual Therapy in a Patient with a Family History of Ovarian Cancer

A client's emotional experiences and reactions to those experiences are influenced by his/her family of origin and direct or indirect interactions with various family members. Contextual therapists propose that a client's satisfaction with a relationship depends on the equity of his/her emotional interactions with family members. When relationships are inequitable, trust between individuals disintegrates. In order to reestablish trust in a relationship, a balance of interests must be restored. If not, imbalances may be passed down to future generations. A case of a woman with a family history of ovarian cancer is reviewed with the principles of contextual therapy in mind. In her family, several legacies have resulted in unbalanced relationships between family members that lead to difficulty in establishing trust within the genetic counseling session.     

Rhetorical Unity and Social Division: A Longitudinal Study of Change in Australian Self-Stereotypes

This paper examines the impact of social division associated with the emergent "race debate" in Australia (and the so-called "Hanson phenomenon") on the consensus of Australian students' stereotypes of their national ingroup. It compares the stereotypes held by a sample of students in 1997 ( N = 20) with those revealed in studies conducted from 1992 onwards ( N = 102). Results provide strong evidence that stereotype consensus was reduced in the current phase of research and post-testing also indicates that participants themselves interpreted this as being the product of political change in Australian society. The findings are consistent with the argument that stereotypes are sensitive to changes in intergroup and intragroup relations, and that they respond to the reality of social division rather than to the rhetoric of unity.     

Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

Low‐SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low‐SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low‐SES, as well as on recruitment, retention, and CRE in low‐SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low‐SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment‐as‐usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.     

Translating the ICAP Theory of Cognitive Engagement Into Practice

ICAP is a theory of active learning that differentiates students’ engagement based on their behaviors. ICAP postulates that I nteractive engagement, demonstrated by co‐generative collaborative behaviors, is superior for learning to C onstructive engagement, indicated by generative behaviors. Both kinds of engagement exceed the benefits of A ctive or P assive engagement, marked by manipulative and attentive behaviors, respectively. This paper discusses a 5‐year project that attempted to translate ICAP into a theory of instruction using five successive measures: (a) teachers’ understanding of ICAP after completing an online module, (b) their success at designing lesson plans using different ICAP modes, (c) fidelity of teachers’ classroom implementation, (d) modes of students’ enacted behaviors, and (e) students’ learning outcomes. Although teachers had minimal success in designing Constructive and Interactive activities, students nevertheless learned significantly more in the context of Constructive than Active activities. We discuss reasons for teachers’ overall difficulty in designing and eliciting Interactive engagement.     

Maternal Depression and Family Media Use: A Questionnaire and Diary Analysis

We describe the association between postpartum depression and the quantity and content of infant media use. Households with depressed mothers viewed twice as much television as households with non-depressed mothers did, and depressed mothers appeared to derive comparatively greater pleasure from television viewing. Maternal depression was associated with an increased exposure to child-directed content by 6–9-month-old infants, although it was not associated with an increased exposure to adult-directed programming. Depressed mothers also reported being less likely to sit and talk with their children during television use or to consult outside sources of information about media. This increase in television exposure without corresponding parental involvement could negatively affect developmental outcomes.     

An interpersonal analysis of pathological personality traits in DSM-5

The proposed changes to the personality disorder section of the Diagnostic and statistical manual of mental disorders (5th ed.) places an increased focus on interpersonal impairment as one of the defining features of personality psychopathology. In addition, a proposed trait model has been offered to provide a means of capturing phenotypic variation on the expression of personality disorder. In this study, the authors subject the proposed DSM-5 traits to interpersonal analysis using the inventory of interpersonal problems-circumplex scales via the structural summary method for circumplex data. DSM-5 traits were consistently associated with generalized interpersonal dysfunction suggesting that they are maladaptive in nature, the majority of traits demonstrated discriminant validity with prototypical and differentiated interpersonal problem profiles, and conformed well to a priori hypothesized associations. These results are discussed in the context of the DSM-5 proposal and contemporary interpersonal theory, with a particular focus on potential areas for expansion of the DSM-5 trait model.     

When is guessing incorrectly better than studying for enhancing memory?

Recently, Kornell, Hays, and Bjork (Journal of Experimental Psychology: Learning, Memory, and Cognition 35:989-998, 2009) demonstrated that incorrect guessing can benefit subsequent memory to a greater degree than can an equivalent amount of study time. We explored this intriguing finding to determine which factors moderate the advantage of incorrect guessing relative to study. In contrast to the findings of Kornell et al., our Experiment 1 revealed that incorrect guessing resulted in worse performance than did studying and that the number of incorrect guesses did not moderate the effect. In contrast, Experiment 2 revealed that the timing of subsequent study moderated the effectiveness of incorrect guessing over study. Final test performance was greater for incorrectly guessed items than for prestudied items when a subsequent study opportunity occurred immediately after the pretrial, whereas the pattern reversed when subsequent study was delayed. This crossover interaction emerged largely because prestudy items showed a classic spacing effect, whereas the guess items did not. One plausible explanation for the absence of a spacing benefit for guess items is that delaying the subsequent study trial increases source-monitoring errors during retrieval, such that participants confuse their original guess with the correctly studied target. However, Experiment 3 provided evidence against this source-monitoring account. We concluded by discussing other possible accounts of why the timing of study could moderate the effectiveness of incorrect guessing.     

Assessing and Managing Risk With Suicidal Individuals

The University of Washington Risk Assessment Protocol (UWRAP) and Risk Assessment and Management Protocol (UWRAMP) have been used in numerous clinical trials treating high-risk suicidal individuals over several years. These protocols structure assessors and treatment providers to provide a thorough suicide risk assessment, review standards of care recommendations for action, and allow for subsequent documentation of information gathered and actions taken. As such, it is a resource for providers treating high-risk populations across multiple contexts (e.g., primary care, outpatient psychotherapy, emergency department). This article describes both the UWRAP and UWRAMP. Taken together, these assessment and risk management tools include (a) assessment questions for gathering information to determine the level of risk, (b) action steps that can be taken to ensure safety, and (c) a companion therapist note where providers document their assessment and actions.     

Diagnosis of ADHD in Adults: What Is the Appropriate DSM-5 Symptom Threshold for Hyperactivity-Impulsivity?

Objective: To empirically identify the appropriate symptom threshold for hyperactivity-impulsivity for diagnosis of ADHD in adults. Method: Participants were 88 adults (M [SD] age = 41.69 [11.78] years, 66% female, 16% minority) meeting formal DSM-IV criteria for ADHD combined or predominantly inattentive subtypes based on a structured diagnostic interview keyed to DSM-IV (Conners' Adult ADHD Diagnostic Interview for DSM-IV [CAADID]). All participants also completed the Conners' Adult ADHD Rating Scale (CAARS), which was normed on the general adult population and includes subscales for DSM-IV inattentive and DSM-IV hyperactive-impulsive symptoms. A T-score threshold of 65 (at least 1.5 SD above population mean) on the CAARS DSM-IV hyperactive-impulsive dimension was used to identify participants with empirically elevated symptom severity. Results: Of 88 participating adults, 48 (55%) had a T-score of at least 65 (1.5 SD) on the CAARS DSM-IV Hyperactive-Impulsive scale. Of these, only 25 (52%) met the DSM-IV cutoff of six hyperactive-impulsive symptoms on the CAADID. Thus, approximately half of those who reported empirically elevated hyperactive-impulsive complaints on the CAARS did not concurrently meet the six-symptom DSM-IV cutoff on the CAADID. An alternative cutoff of four hyperactive-impulsive symptoms on the CAADID captured 39 (81%) cases identified by the CAARS. Conclusion: In adults, mandating at least six hyperactive-impulsive symptoms excludes a significant percentage (almost half) of adults who are at least 1.5 SD above the population mean on a dimensional measure of hyperactivity-impulsivity. These data provide a compelling basis for lowering the symptom threshold of hyperactivity-impulsivity for adults in the DSM-5.