Exposure Quality in Cognitive Behavioral Treatment for Youth Anxiety Disorders—Predictors and Associations with Outcomes

Journal of Child and Family Studies - To optimize cognitive behavioral therapy (CBT) outcomes for anxiety disorders in youth, more knowledge is needed about how specific CBT components work....     

What Does Diffusion Tensor Imaging Reveal About the Brain and Cognition in Fetal Alcohol Spectrum Disorders?

Over the past 5 years, Diffusion Tensor Imaging (DTI) has begun to provide new evidence about the effects of prenatal alcohol exposure on white matter development. DTI, which examines microstructural tissue integrity, is sensitive to more subtle white matter abnormalities than traditional volumetric MRI methods. Thus far, the available DTI data suggest that white matter microstructural abnormalities fall on a continuum of severity in Fetal Alcohol Spectrum Disorder (FASD). Abnormalities are prominent in the corpus callosum, but also evident in major anterior-posterior fiber bundles, corticospinal tracts, and cerebellum. These subtle abnormalities are correlated with neurocognitive deficits, especially in processing speed, non-verbal ability, and executive functioning. Future studies using larger samples, increasingly sophisticated DTI methods, and additional functional MRI connectivity measures will better characterize the full range of abnormalities in FASD. Ultimately, these measures may serve as indices of change in future longitudinal studies and in studies of interventions for FASD.     

Clinician Perspectives of Diagnosis and Perceived Client Change in “Real World” Psychotherapy for Youth Emotional and Behavioral Disorders

We investigated the extent to which clinician-assigned diagnoses of emotional and behavioral disorders and clinicians’ perceptions of client change are consistent with structured measures of youth clinical functioning and parent/family characteristics within the context of usual care or “real world” psychotherapy. A total of 54 therapists from two publicly-funded youth outpatient mental health clinics and 128 youths and parents from the therapists’ combined caseloads were included in the study. Clinician-assigned diagnosis and youth and family demographics were collected at the initial visit, clinician-reported perceived client change was collected at 6-month follow-up, and structured measures of youth clinical functioning and parent/family characteristics were collected at both time points. Results indicate some overlap between clinician-assigned diagnosis, clinician-reported perceived client change, and structured measures of youth clinical functioning and parent/family characteristics after controlling for demographic factors. Results are discussed in terms of implications for the implementation of evidence-based practices in real world community settings.     

What Do Youth Referred for Anxiety Problems Worry About? Worry and Its Relation to Anxiety and Anxiety Disorders in Children and Adolescents

This study examined worry and the parameters of worry that may be associated with clinical anxiety in a sample of 119 children and adolescents referred to a childhood anxiety disorders specialty clinic. Using an interviewing procedure, results indicated that the types of worries reported by the children were similar to those reported in previous studies of nonreferred community children. Also similar to previous community studies were findings showing moderate but significant correlations between different indices of worry (i.e., number, intensity, and frequency of the worries) and children's scores on self-rating scales of anxiety. Results further indicated that worry contributed additional variance beyond that of anxiety in predicting fear. In addition, intensity differentiated clinic children's worries from nonreferred children's. Intensity, and number of worries differentiated subsamples of children within the clinic-referred sample (i.e., children with overanxious disorder or generalized anxiety disorder and children with simple phobia). The importance of examining children's worries to further understand anxiety and its disorders in youth is discussed.     

The Challenge of Integrated Care for Mental Health: Leaving the 50 minute hour and Other Sacred Things

A growing body of research has demonstrated the effectiveness of integrating mental/behavioral healthcare with primary care in improving health outcomes. Despite this rich literature, such demonstration programs have proven difficult to maintain once research funding ends. Much of the discussion regarding maintenance of integrated care has been focused on lack of reimbursement. However, provider factors may be just as important, because integrated care systems require providers to adopt a very different role and operate very differently from traditional mental health practice. There is also great variability in definition and operationalization of integrated care. Provider concerns tend to focus on several factors, including a perceived loss of autonomy, discomfort with the hierarchical nature of medical care and primary care settings, and enduring beliefs about what constitutes “good” treatment. Providers may view integrated care models as delivering substandard care and passively or actively resist them. Dissemination of available data regarding effectiveness of these models is essential (e.g. timeliness of treatment, client satisfaction). Increasing exposure and training in these models, while maintaining the necessary training in traditional mental health care is a challenge for training at all levels, yet the challenge clearly opens new opportunities for psychology and psychiatry.     

Are Immigrants from Asia Healthier than Immigrants from Other Regions?: Self-reported Health Status and Functional Difficulties of Immigrants in the USA

This study examines how regions of origin are related to immigrant health status in the USA. This paper uses the National Health Interview Survey to examine health status differences between East and Southeast Asian immigrants and immigrants from other regions. The models control for duration, socioeconomic factors, and behavioral factors. Two health indicators are examined: self-reported health and functional difficulties. Results from ordered logit regression analyses demonstrate that some of the regions of birth do significantly predict differences in health for immigrants. Specifically, immigrants from Central America and the former Soviet Union do exhibit significant health disadvantages when compared with immigrants from East and Southeast Asia. The duration effect was positively related to functional difficulties but not to self-reported health status. Overall, economic resources and education typically have a strong relationship to the measures of immigrants’ physical health. It was also found that drinking is persistently associated with better measures of physical health while smoking appears to have the opposite effect.     

Letters of Recommendation for the Predoctoral Internship in Medical Schools and Other Settings: Do They Enhance Decision Making in the Selection Process?

Since the 1970s, letters of recommendation to medical and other internship settings have surfaced as important variables in the internship selection process. However, several studies have challenged their value in the selection process, specifically by pointing out that these letters have an overly positive bias and fail to address applicant weaknesses. Our study, using the Linguistic Inquiry and Word Count text analysis method, developed a quantitative profile for a sample of letters of recommendation, determined whether letters differentiated among applicants with regard to positive/negative attributions, evaluated letters for positive and negative bias, and investigated potential gender bias of writers toward applicants. Results indicated that writers apply positive and negative attributions homogeneously across applicants, thus, rendering applicant differentiation on this basis impossible. Also, results demonstrated that letters of male and female writers were not biased toward male or female applicants. These findings, in combination with previous studies, question the utility of letters of recommendation as presently structured. Possible modifications are discussed.     

Impact of a Father Figure’s Presence in the Household on Children’s Psychiatric Diagnoses and Functioning in Families at High Risk for Depression

The consequences of living in single-parent households on children’s wellbeing are well documented, but less is known about the impact of living in single-mother households among children with high familial risk for depression. Utilizing data from an ongoing three-generation study of high-risk families, this preliminary study examined a sample of 161 grandchildren of probands diagnosed with major depressive disorder, comparing those in single-parent households to those in dual-parent households with household status defined as the full-time presence of a resident male in the home. High-risk children were compared across households in terms of psychiatric diagnoses (measured by Schedule for Affective Disorders and Schizophrenia for School-Age Children; K-SADS-PL) and global functioning (assessed by Global Assessment Scale, child version; C-GAS). Results indicated that high-risk children in single-parent households had 4.7 times greater odds for developing a mood disorder and had significantly lower mean C-GAS scores (p = 0.01) compared to those in dual-parent households. Differences remained significant when controlling for household income, child’s age, and either parent’s depression status. There were no significant differences between high-risk children across households when household status was instead defined as legal marital status. This study has several limitations: sample size was small, probands were recruited from a clinical population, and participants had not passed completely through the period of risk for adult psychiatric disorders. These findings point towards the importance of identifying and closely monitoring children at risk for depression, particularly if they reside in households without a resident father figure.     

The Structure and Direction of Emotion in Elite Sport: Deconstructing Unhealthy Paradigms and Distorted Norms for the Body

Research shows a connection between negative perceptions of emotion, emotional suppression, and athletes’ subsequent disregard for their health (Lee Sinden in J Relig Health 2010, J Clin Sport Psychol 4:241–256, 2012). In light of recent research, the following paper explores the structure and direction of emotion in order to break down historical misconceptions in elite sport. This paper also discusses emotional control, as a direction that can lead to suppression and health problems, and gives suggestions for emotion education and further directions.     

Mapping the Personality Psychopathology Five Domains Onto DSM–IV Personality Disorders in Dutch Clinical and Forensic Samples: Implications for DSM–5

The Personality Psychopathology Five (PSY–5) model represents 5 broadband dimensional personality domains that align with the originally proposed DSM–5 personality trait system, which was eventually placed in Section III for further study. The main objective of this study was to examine the associations between the PSY–5 model and personality disorder criteria. More specifically, we aimed to determine if the PSY–5 domain scales converged with the alternative DSM–5 Section III model for personality disorders, with a particular emphasis on the personality trait profiles proposed for each of the specific personality disorder types. Two samples from The Netherlands consisting of clinical patients from a personality disorder treatment program (n = 190) and forensic psychiatric hospital (n = 162) were used. All patients had been administered the MMPI–2 (from which MMPI–2–RF PSY–5 scales were scored) and structured clinical interviews to assess personality disorder criteria. Results based on Poisson or negative binomial regression models showed statistically significant and meaningful associations for the hypothesized PSY–5 domains for each of the 6 personality disorders, with a few minor exceptions that are discussed in detail. Implications for these findings are also discussed.     

Does familiarity or conflict account for performance in the word-stem completion task? Evidence from behavioural and event-related-potential data

The conflict monitoring theory (CMT) assumes that word-stems associated with several completions should lead to crosstalk and conflict due to underdetermined responding situation (Botvinick et al. in Psychol Rev 108(3):624–652, 2001). In contrast, the Multiple-Read-Out-Model (MROM) of Jacobs and Grainger (J Exp Psychol 20(6): 1311–1334, 1994) predicts a high level of general lexical activity (GLA) for word-stems with many completions, indicating a higher stimulus familiarity because these stems are more probable to be read. We compared word-stems with several completions against word-stems with one possible completion while measuring response times and electrophysiological recordings. Slowest response times and a distinct FN400 component, which has previously been related to the concept of familiarity (Curran in Memory Cogn 28(6):923–938, 2000), were apparent for word-stems that could only be associated with a single response. These findings support the claims of the MROM. Furthermore, the lack of the N2-component for word-stems with several completions continues to challenge the EEG-extension of the CMT (Yeung et al. in Psychol Rev 111(4):2004).     

Extended functionalism,radical enactivism,and the autopoietic theory of cognition: prospects for a full revolution in cognitive science

Recently, Michael Wheeler (2017) has argued that despite its sometimes revolutionary rhetoric, the so called 4E (embodied-embedded-enacted-extended) cognitive movement, even in the guise of ‘radical’ enactivism (REC), cannot achieve a full revolution in cognitive science. A full revolution would require the rejection of two essential tenets of traditional cognitive science, namely internalism and representationalism. Whilst REC might secure antirepresentationalism, it cannot do the same, so Wheeler argues, with externalism. In this paper, expanding on Wheeler’s analysis (2017), we argue that what compromises REC’s externalism is the persistence of cognitively relevant asymmetries between its purported cognitive systems and the environment. Complementarily, we argue that an antirepresentationalist ancestor of enactivism, the autopoietic theory of cognition, is able to deliver and secure externalism, thus offering the explosive combination (i.e., antirepresentationalism plus externalism) that Wheeler claims us needed for a revolution in cognitive science.     

Do children with autism use inner speech and visuospatial resources for the service of executive control? Evidence from suppression in dual tasks

Three experiments used dual‐task suppression methodology to study the use of inner speech and visuospatial resources for mediating central executive performance by children with autism (CWA) and group‐matched typically developing (TD) controls. Expt 1 revealed that CWA did not recruit inner speech to facilitate arithmetic task‐switching performance: there was no effect of articulatory suppression (AS) on completion time for CWA compared to the TD group. Expt 2 revealed that suppression of visuospatial resources disrupted the task‐switching performance of both CWA and TD groups. It also confirmed that the task‐switching performance of CWA was significantly slowed by visuospatial compared to AS. Expt 3 showed that CWA also did not employ inner speech, compared to visuospatial resources, for implementing planning movements. Overall, compared to the mixture of representations used by the TD group for problem solving, CWA seemed to use visuospatial working memory resources but not inner speech to service executive control.     

Where am I and how will I get there from here? A role for posterior parietal cortex in the integration of spatial information and route planning

The ability of an organism to accurately navigate from one place to another requires integration of multiple spatial constructs, including the determination of one's position and direction in space relative to allocentric landmarks, movement velocity, and the perceived location of the goal of the movement. In this review, we propose that while limbic areas are important for the sense of spatial orientation, the posterior parietal cortex is responsible for relating this sense with the location of a navigational goal and in formulating a plan to attain it. Hence, the posterior parietal cortex is important for the computation of the correct trajectory or route to be followed while navigating. Prefrontal and motor areas are subsequently responsible for executing the planned movement. Using this theory, we are able to bridge the gap between the rodent and primate literatures by suggesting that the allocentric role of the rodent PPC is largely analogous to the egocentric role typically emphasized in primates, that is, the integration of spatial orientation with potential goals in the planning of goal-directed movements.     

Investigations of the optical and EPR spectra for VO2+ in NaHC2O4 · H2O single crystals

Theoretical calculations of the optical absorption and electron paramagnetic resonance (EPR) spectra of VO²⁺ in NaHC₂O₄?·?H₂O single crystals were performed using the complete diagonalization energy matrix method (CDM) and the perturbation theory method (PTM) for the 3d ¹ electronic configuration. The calculated results are in good agreement with experimental results. The negative signs of hyperfine structure constants A _∥ and A _⊥ for VO²⁺ in NaHC₂O₄·H₂O single crystals are suggested from the calculations. Comparison of the two calculation methods indicates that the PTM is a good approximation of CDM and that both theoretical methods are valid in interpretation of the optical and EPR spectra for VO²⁺ ions in NaHC₂O₄?·?H₂O crystals.     

A Lutheran Reflection on The One Mediator,The Saints,and Mary1 in Relation to the Question: How Do Lutherans Understand Prayer for Other People?2

Abstract : In this article, the author offers a critical, appreciative appraisal of The One Mediator, The Saints, and Mary (1992), which was the publication that emerged from the eighth round of the U.S. Lutheran‐Catholic Dialogue. Writing from a Lutheran perspective and using the Joint Declaration on the Doctrine of Justification (JDDJ, October 31, 1999) as a critical hermeneutical lens, the author points to Luther's theological conviction concerning how Mary—the mother of the Lord Jesus Christ—and departed saints are to be regarded. Luther's emphasis on Christ the only Mediator was highlighted. Reflection on this text was done in light of the theme of the dialogue's eleventh round, “The Hope of Eternal Life.” Prayer is always in and through Jesus Christ.