Placebo effects in developmental disabilities: implications for research and practice

Recent clinical trials of secretin in children with autism showed robust placebo effects and no benefit of secretin over placebo. This article explores the reasons for the observed placebo effects, focusing on the heightening of positive expectancy by media attention and by the sensory experiences associated with intravenous injections. Comparisons are drawn with research involving other novel treatments and other clinical populations of children with developmental disabilities and neurobehavioral disorders. Research regarding mechanisms of placebo effects is reviewed, including patient and clinician attributes, expectancy effects, participation effects, changes in caregiver behavior, and conditioning. New evidence regarding the biological basis of placebo effects is briefly presented. Since placebo effects are ubiquitous and may operate by a variety of mechanisms, research design is critical in designing clinical trials and in evaluating other outcomes research. Measurement issues important for research in developmental disabilities are emphasized. Ethical concerns have been raised regarding the use of placebo in clinical research, but current analysis suggests that placebo controls are necessary and defensible on ethical grounds, if certain conditions are met. The study of placebo effects ("placebology") holds great promise as a new area of research in therapeutics. The author's research in the potential augmentation of stimulant effects in children with attention deficit/hyperactivity disorder (ADHD) by adding placebo in open label is briefly presented. The placebo has always been integral to the practice of medicine, but advances in scientific medicine and medical ethics have diminished the role and use of placebo in practice. An innovative approach to the ethical use of placebo is proposed.     

Rising verbal intelligence scores: implications for research and clinical practice

Evidence suggests that scores on various intelligence tests have been rising at a fast rate. To find out whether performance on the Wechsler Adult Intelligence Scale (WAIS) Vocabulary subtest has also been rising, the authors searched major psychology journals for investigations involving healthy younger and older adult participants and collected the reported WAIS Vocabulary scores. The meta-analysis shows that WAIS Vocabulary scores have been rising at the rate of 0.117/year (corresponding to 1.52 IQ points/decade) for younger adults and 0.367/year (corresponding to 4.79 IQ points/decade) for older adults.     

Trust in leadership: meta-analytic findings and implications for research and practice

In this study, the authors examined the findings and implications of the research on trust in leadership that has been conducted during the past 4 decades. First, the study provides estimates of the primary relationships between trust in leadership and key outcomes, antecedents, and correlates (k = 106). Second, the study explores how specifying the construct with alternative leadership referents (direct leaders vs. organizational leadership) and definitions (types of trust) results in systematically different relationships between trust in leadership and outcomes and antecedents. Direct leaders (e.g., supervisors) appear to be a particularly important referent of trust. Last, a theoretical framework is offered to provide parsimony to the expansive literature and to clarify the different perspectives on the construct of trust in leadership and its operation.     

The importance of distinguishing between constructs and methods when comparing predictors in personnel selection research and practice

The authors highlight the importance and discuss the criticality of distinguishing between constructs and methods when comparing predictors. They note that comparisons of constructs and methods in comparative evaluations of predictors result in outcomes that are theoretically to conceptually uninterpretable and thus potentially misleading. The theoretical and practical implications of the distinction between predictor constructs and predictor methods are discussed, with three important streams of personnel psychology research being used to frame this discussion. Researchers, editors, reviewers, educators, and consumers of research are urged to carefully consider the extent to which the construct-method distinction is made and maintained in their own research and that of others, especially when predictors are being compared. It is hoped that this discussion will reorient researchers and practitioners toward a more construct-oriented approach that is aligned with a scientific emphasis in personnel selection research and practice.     

Integrative approaches to couple therapy: implications for clinical practice and research

Although meta-analyses affirm that various treatments for couple distress produce statistically and clinically significant outcomes, research findings also indicate that a large percentage of couples fail to benefit or subsequently deteriorate following current therapies. Based on these findings, we advocate potential advantages of integrative approaches to couple therapy. We distinguish among assimilative, transtheoretical, and pluralistic approaches to integration and describe exemplars of each. Integrative approaches to couple therapy are compared to distillatory or common factors approaches emphasizing common elements of treatment components, therapist characteristics, and client or relationship attributes. We argue that clinical practice of integrative approaches to couple therapy requires conceptual and clinical decision-making skills transcending those of any one theoretical modality and emphasizing the selection, sequencing, and pacing of diverse interventions in a coherent manner. We conclude with implications of integrative couple-based treatments for future research.     

The mismatch effect: when testosterone and status are at odds

Why do some people strive for high status, whereas others actively avoid it? In the present studies, the authors examined the psychological and physiological consequences of a mismatch between baseline testosterone and a person's current level of status. The authors tested this mismatch effect by placing high and low testosterone individuals into high or low status positions using a rigged competition. In Study 1, low testosterone participants reported greater emotional arousal, focused more on their status, and showed worse cognitive functioning in a high status position. High testosterone participants showed this pattern in a low status position. In Study 2, the emotional arousal findings were replicated with heart rate, and the cognitive findings were replicated using a math test. In Study 3, the authors demonstrate that testosterone is a better predictor of behavior than self-report measures of the need for dominance. Discussion focuses on the value of measuring hormones in personality and social psychology.     

The postmodern counsellor: Some implications for practice,theory, research and professionalism

What is postmodernism? What are the implications of the death of God, science and the subject for counselling? Further questions include: To what extent does postmodernism, show that behavioural, humanistic, existential, and most psychoanalytic theories are delusional in that they would have the clients/patients believe that they are the core, the centre, the subject? What are the dangers of seeing ‘others’ practically, theoretically and when conducting research as either enhancing our narcissism and/or the counselling order? In terms of an ethical practice, can the postmodern counsellor stop counselling from reverting to a technique orientated mechanism of professional vested interests, and instead find a better way for us all to put the other first?     

Effects of speech accents on interpersonal evaluations: implications for counseling practice and research

This article reviews literature from the fields of psycholinguistics, communications, and social psychology that has examined the effects of speech accents (i.e., regional, national, and international variations in same-language use) on interpersonal attitudes, casual attributions, and subsequent behaviors. The authors link selected findings from this literature to the field of counseling to show that these findings can inform service delivery, particularly counseling conducted with ethnic minority and immigrant populations in the United States. Implications for practice and ideas for future research in this area are also discussed.     

Prevalence of mood symptoms and depressions during pregnancy: implications for clinical practice and research

A review of the literature demonstrates that the incidence of new mental disorders and their prevalence during pregnancy is similar to the 12-month incidence of mental disorders in women during other periods of their lives. The prevalence of severe mood, behavior, and cognitive symptoms during pregnancy is rather high. Severe mental symptoms during pregnancy have been reported to be associated with an increased rate of complications during pregnancy and delivery, preterm deliveries, low birth weight, a higher rate of postpartum depression, and a longer-term impact on the offspring's development. Several pre-pregnancy risk factors to develop dysphoric symptoms have been reported, but their utility for primiparous women with no previous history of mental disorders is unclear. The association of mental symptoms with general symptoms and biological changes during pregnancy is also unclear. Given the short- and long-term impact of dysphoric symptoms and stress during pregnancy on mother and child, efficacious, efficient, and safe prevention and treatment modalities are essential and achievable. Clarification of the nature and phenotyping of mental and general symptoms during pregnancy is an important step for the development of effective interventions.     

Retaking ability tests in a selection setting: implications for practice effects,training performance,and turnover

This field study investigated the effect of retaking identical selection tests on subsequent test scores of 4,726 candidates for law enforcement positions. For both cognitive ability and oral communication ability selection tests, candidates produced significant score increases between the 1st and 2nd and the 2nd and 3rd test administrations. Furthermore, the repeat testing relationships with posthire training performance and turnover were examined in a sample of 1,515 candidates eventually selected into the organization. As predicted from persistence and continuance commitment rationales, the number of tests necessary to gain entry into the organization was positively associated with training performance and negatively associated with turnover probability.     

Performance evaluation: On choosing to know the related attributes of others when we know their performance

It was hypothesized that people will choose to find out about the performance attributes of others who perform similarly to themselves if they believe the attributes are related to performance. Subjects within a group of nine were supposedly given different amounts of practice prior to taking a test on which performance was said to be either related or unrelated to practice. After taking the test, each subject was given his score, his rank order in the group, and the score obtained by each of the other group members. The subject was then allowed to find out about the number of items practiced by one other person in the group. A second choice was also given. On both first and second choices, subjects in the related condition chose to learn about others who were adjacent to them in the rank order. Subjects in the unrelated condition chose to learn about others with extreme scores. First choices in both conditions were strongly biased upward, supporting the unidirectional drive hypothesis.     

Personality and police selection: Trait differences in successful and non-successful applicants to the metropolitan police

Three hundred and nineteen applicants to the Metropolitan Police Force (270 men and 49 women) were asked to complete the EPQ. Successful candidates were more extraverted and less neurotic than unsuccessful ones. No differences were found for P or L scores. All candidates ‘faked good’ displaying unusually high E and L scores and low N and P scores. The 64 applicants who declined to complete the questionnaire were less likely to be accepted into the force than the rest. It is hypothesized that this is because they are less outgoing types than their more willing counterparts. There was no difference in acceptance rates for men and women.     

Variations of the Bender-Gestalt Test: implications for training and practice

Although the Bender-Gestalt Visual Motor Test has been a popular and influential clinical assessment instrument for the last half century, authoritative opinion and a substantial research literature are often inconsistent or contradictory. This paper documents variations in designs, administration procedures, forms, and applications to particular populations. A careful review of scoring systems indicates the current status of objective approaches as contrasted with interpretation that is global, intuitive, and subjective. Some implications of these variations and interpretive procedures for training and assessment practice are discussed. The major conclusions of the review are summarized in seven points.     

Pilot personality and crew coordination: implications for training and selection

The performance of pilots can be construed as a product of skill, attitude, and personality factors. Although a great deal of effort within the aviation community has been focused on ensuring technical expertise, and new efforts highlight attitudes associated with crew coordination, personality factors have been relatively unexplored. Further, it is argued that past failures to find linkages between personality and performance were due to a combination of inadequate statistical modeling, premature performance evaluation, and/or the reliance on data gathered in contrived as opposed to realistic situations. The goal of the research presented in this article is to isolate subgroups of pilots along performance-related personality dimensions and to document limits on the impact of crew coordination training between the groups. Two samples of military pilots were surveyed in the context of training in crew coordination. Three different profiles were identified through cluster analysis of personality scales. These clusters replicated across samples and predicted attitude change following training in crew coordination.     

Rational emotive behavior therapy research: What we know and what we need to know

Rational emotive behavior therapy (REBT) has achieved positive results in quantitative reviews of treatment outcome studies. In part because of methodological limitations of these studies, however, the generalizability of their favorable results to routine clinical practice is unknown. Also unknown are the clinical significance of outcomes achieved by REBT, the contribution made by its distinctive and specialized procedures, and the types of patients for whom REBT is particularly useful. Recommendations are provided for refining our knowledge of the effectiveness of REBT.     

The prematurity stereotype: Empirical evidence and implications for practice

The prematurity stereotype is defined as a set of biased beliefs about infants who are identified as having been born prematurely. This article reviews studies that have explored how this prematurity stereotype may negatively influence adults' perceptions of, expectations for, and behavior toward premature infants. The findings from these studies are considered in the context of more general knowledge about how expectations can influence behavior and result in self-fulfilling prophecies. Recent research designed to investigate how prematurity stereotyping can be reduced also is described and evaluated. Finally, the implications of this program of research for intervention with parents of premature infants and suggestions for future research directions are discussed.     

Historically grounding the practice of psychology: implications for professional training

The author explores 3 ways the history of psychology can be made relevant to professional training in clinical psychology. Focusing on the practitioner-scholar model of clinical professional training, he argues that 3 central facets of historical understanding can be wedded to existing goals of professional training: (a) providing an interdisciplinary context for psychology, (b) addressing concerns about humans in the field, and (c) mediating theory-practice tensions that often exist in professional training. Suggestions are also made for encouraging historical understanding as essential to fostering critical self-reflection among students preparing for careers in professional psychology.     

Emotional sequelae of abortion: implications for clinical practice

For women in therapy who have had abortions, an exploration of the context and aftermath of each abortion has been suggested. This inquiry should include: characteristics of the woman herself before and at the time of the abortion, the nature of the interpersonal and cultural milieu at the time, characteristics of the medical environment and procedure, and any events subsequent to the abortion that may evoke regrets about the earlier decision.
Whether or not such an inquiry results in the identification of unresolved issues surrounding the abortion, it is likely to enhance one's general understanding of the client. Exploring a woman's decision to have an abortion can bring into relief developmental and family issues, relationship conflicts, and her aspirations for education, work, and family. A woman's approach to establishing and asserting her priorities and values in making difficult personal decisions becomes clear as does her ability to tolerate and resolve the ambivalence inherent in making difficult decisions.
In psychotherapy, it is important to understand and address those aspects of experience that women have difficulty resolving. Hence, the emphasis on categories of experience that may have a negative impact on a woman's emotional well-being after abortion. Nevertheless, the clinician should remember that even women who report negative post-abortion sequelae overwhelmingly report that they feel that the decision was the right one for them. Having ambivalent feelings to resolve does not necessarily mean that one has made a wrong choice, only that one has made an emotionally significant choice with far-reaching personal implications, in a sociocultural environment that reinforces the ambivalence inherent in such decisions.