Therapists’ Thought-Action Fusion Beliefs Predict Utilization of Exposure in Obsessive-Compulsive Disorder

Although exposure and response prevention (ERP) is considered the gold standard for the treatment of obsessive-compulsive disorder (OCD), it is rarely used in clinical practice. Therapists’ beliefs about ERP affect its utilization, as previous research suggests, but the role of therapists’ cognitive biases is unclear. In particular, susceptibility to thought-action fusion (TAF) may be related to the underutilization of ERP in OCD.Therapists (N = 353) were divided into those recommending (ERP+, n = 228) and not recommending ERP (ERP−, n = 125) as treatment for an OCD case example. TAF in therapists was assessed using behavioral and self-report measures (TAFS).TAF was higher in the ERP− than the ERP+ group, with a small to moderate effect size (0.2 ≤ d ≤ 0.4). ERP− therapists showed more avoidance and neutralizing behavior and a stronger emotional response than the ERP+ therapists during the experimental task. Moreover, higher TAF as measured by the TAFS was associated at a small magnitude with lower likelihood of using ERP in the therapists’ actual clinical practices.Therapists’ cognitive biases should be addressed in their training in order to increase the dissemination of evidence-based treatment (i.e., ERP) and thus improve the treatment of OCD.     

Empirically Defining Treatment Response and Remission in Obsessive-Compulsive Disorder Using the Obsessive-Compulsive Inventory–Revised

In clinical trials of obsessive-compulsive disorder (OCD), clinical outcomes are generally measured using lengthy clinician-administered interviews. However, in routine clinical practice, many clinicians lack the time to administer such instruments. This study evaluated cutoffs for treatment response and remission in OCD using the self-rated Obsessive-Compulsive Inventory—Revised (OCI-R). Data from 349 patients in three clinical trials of cognitive-behavioral therapy for OCD were pooled for analysis. The OCI-R was compared to gold-standard criteria for response and remission based on the clinician-administered Yale–Brown Obsessive Compulsive Scale and the Clinical Global Impression Scale. The results showed that a ≥40% reduction on the OCI-R was the optimal cutoff for treatment response, with a sensitivity of 0.72 and a specificity of 0.79. For remission status, the optimal cutoff was ≤8 points on the OCI-R, with a sensitivity of 0.57 and specificity of 0.83. Results from additional analyses using the 12-item version of the OCI were similar. These cutoffs provide a simple and time-efficient way to help determine treatment response and remission in OCD when the administration of clinician-administered instruments is unfeasible.     

Is Heightened Disgust Propensity Truly a Risk Factor for Contamination-Related Obsessive-Compulsive Disorder?

Disgust propensity (DP) has been conceptualized as a stable personality trait that confers risk for contamination-related OCD (C-OCD). However, the extent to which DP leads to the subsequent development of C-OCD is unclear. In fact, the presence of C-OCD might lead to an increase in DP rather than the inverse. The present study was aimed to test this hypothesis in a large clinical sample of OCD patients (≥ 21 years of age) with (C-OCD; n = 56) and without (NC-OCD; n = 103) contamination-related symptoms that completed measures of OCD symptoms, depression, anxiety, and DP. DP was assessed twice, in reference to the present situation (T1) and to when the participant was 18 years old (T0). The two groups did not significantly differ in DP at T0. However, C-OCD participants reported higher DP scores than NC-OCD at T1. Furthermore, the T1 vs T0 difference in DP was significant only in the C-OCD group. Subsequent analyses also showed that T1 DP levels, but not T0 levels, significantly predicted contamination-related symptoms. Despite study limitations, these findings question the role of DP as a risk factor for C-OCD.     

Is Gender Identity Disorder in Children a Mental Disorder?

Empirical studies were evaluated to determine whether Gender Identity Disorder (GID) in children meets the Diagnostic and Statistical Manual of Mental Disorders-4th Edition (DSM-IV, American Psychiatric Association, 1994) definitional criteria of mental disorder. Specifically, we examined whether GID in children is associated with (a) present distress; (b) present disability; (c) a significantly increased risk of suffering death, pain, disability, or an important loss of freedom; and if (d) GID represents dysfunction in the individual or is simply deviant behavior or a conflict between the individual and society. The evaluation indicates that children who experience a sense of inappropriateness in the culturally prescribed gender role of their sex but do not experience discomfort with their biological sex should not be considered to have GID. Because of flaws in the DSM-IV definition of mental disorder, and limitations of the current research base, there is insufficient evidence to make any conclusive statement regarding children who experience discomfort with their biological sex. The concluding recommendation is that, given current knowledge, the diagnostic category of GID in children in its current form should not appear in future editions of the DSM.     

Does Exposure and Response Prevention Behaviorally Activate Patients With Obsessive-Compulsive Disorder? A Preliminary Test

Exposure and response prevention (ERP) and behavioral activation (BA) are effective treatments for obsessive-compulsive disorder (OCD) and depression, respectively. Patients with OCD often exhibit depression; furthermore, ERP for OCD is associated with reduced depressive symptoms. To our knowledge, no study has examined whether ERP itself functions to behaviorally activate patients with concurrent OCD and depressive symptoms. This prospective study was designed to test the hypotheses that (a) OCD exposure hierarchy completion, increased BA, and depressive symptom reduction would all be related, and (b) pre- to posttreatment changes in BA would mediate the direct effect of OCD hierarchy completion on posttreatment depressive symptoms, even after controlling for pretreatment depressive symptoms, pretreatment BA, pre- to posttreatment reductions in OCD symptoms, treatment duration, and antidepressant medication use. Patients (N = 90) with a primary diagnosis of OCD who received residential ERP for OCD completed a self-report battery at pre- and posttreatment. Exposure hierarchy completion, increases in BA, and decreases in depression were all significantly correlated (rs ranged .33 to .44). The effect of hierarchy completion on posttreatment depressive symptoms was fully mediated by pre- to posttreatment changes in BA. Findings highlight the potential for ERP to exert antidepressant effects by behaviorally activating patients. Limitations, clinical implications, and future directions are discussed.     

Relational Learning in Pigeons?

Two experiments investigated whether discrimination learning and transposition by pigeons were facilitated by the opportunity to compare rectangles differing in luminance or stars differing in number of vertices. In Experiment 1, one group was trained with stimuli from the same dimension appearing simultaneously on each trial, but for a second group such stimuli appeared on separate trials. The opportunity to compare stimuli from the same dimension on a single trial facilitated the learning of the luminance discrimination but not of the stars discrimination. Such comparison also resulted in greater luminance but not greater stars transposition. Using a different training procedure, Experiment 2 confirmed that the opportunity for comparison facilitated a luminance discrimination. The results for the star discrimination are entirely consistent with 'absolute' theories of discrimination learning; but the results for the luminance discrimination suggest some kind of 'relational' learning. Given the difference between the star and luminance discriminations, a low-level, sensory theory of relational learning seems most consistent with the data.     

Presidential Address: Are the Obsessive-Compulsive Related Disorders Related to Obsessive-Compulsive Disorder? A Critical Look at DSM-5’s New Category

The 5^th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) includes a new class of obsessive-compulsive and related disorders (OCRDs) that includes obsessive-compulsive disorder (OCD) and a handful of other putatively related conditions. Although this new category promises to raise awareness of underrecognized and understudied problems, the empirical validity and practical utility of this new DSM category is questionable. This article critically examines the arguments underlying the new OCRD class, illuminates a number of problems with this class, and then discusses implications for clinicians and researchers.     

Do Bettors Correctly Perceive Odds? Three Studies of How Bettors Interpret Betting Odds as Probabilistic Information

This paper reports on three studies investigating how accurately bettors (=people who regularly bet on sports events) interpret the probabilistic information implied by betting odds. All studies were based on data collected by web surveys prompting a total of 186 experienced bettors to convert sets of representative odds into frequency judgments. Bayesian statistical methods were used to analyze the data. From the results, the following conclusions were made: (i) On the whole, the bettors produced well‐calibrated judgments, indicating that they have realistic perceptions of odds. (ii) Bettors were unable to consciously adjust judgments for different margins. (iii) Although their interval judgments often covered the estimates implied by the odds, the bettors tended to overestimate the variation of expected profitable bets between months. The results are consistent with prior research showing that people tend to make accurate probability judgments when faced with tasks characterized by constant and clear feedback. Copyright © 2015 John Wiley & Sons, Ltd.     

Sudden Gains: How Important Are They During Exposure and Response Prevention for Obsessive-Compulsive Disorder?

Symptom reduction over the course of cognitive-behavioral therapy is not always distributed evenly across sessions. Some individuals experience a sudden gain, defined as a large, rapid, and stable decrease in symptoms during treatment. Although research documents a link between sudden gains and treatment for depression and anxiety, findings in the context of obsessive-compulsive disorder (OCD) treatment are mixed. The present study investigated the relationship between sudden gains and treatment outcome in 44 adults with OCD and addressed limitations of previous studies by measuring OCD symptoms dimensionally and comparing individuals who experience sudden gains to those who experience gradual gains of similar magnitude. Sudden gains were observed among 27% of participants, with highest rates among individuals with primary contamination symptoms. Participants who experienced a sudden gain had greater OCD symptom reductions at posttreatment (but not at follow-up), and this difference did not persist after controlling for gain magnitude. Thus, the importance of sudden gains during OCD treatment may be limited. Findings are discussed in light of inhibitory learning models of cognitive-behavioral therapy.     

Affective-Evaluative Learning in Humans: A Form of Associative Learning or Only an Artifact?

The status of evaluative conditioning (EC) as a distinct form of associative learning was called in question by Field and Davey (1997, 1998, 1999), who argued that in the typical visual EC paradigm, nonassociative visual concept learning is responsible for the evaluative changes observed. Especially, the use of only within-subject control conditions instead of independent control groups was criticized. The present three experiments show (a) that EC effects can be demonstrated within another sensory modality than visual perception and (b) that EC effects are demonstrable in a between-subject design (including a successful replication attempt). A further result was that these EC effects do not require participants' conscious awareness. The data provide no support for an artifactual account of EC but suggest an interpretation of EC as a form of associative learning.     

Is Probabilistic Evidence a Source of Knowledge?

We report a series of experiments examining whether people ascribe knowledge for true beliefs based on probabilistic evidence. Participants were less likely to ascribe knowledge for beliefs based on probabilistic evidence than for beliefs based on perceptual evidence (Experiments 1 and 2A) or testimony providing causal information (Experiment 2B). Denial of knowledge for beliefs based on probabilistic evidence did not arise because participants viewed such beliefs as unjustified, nor because such beliefs leave open the possibility of error. These findings rule out traditional philosophical accounts for why probabilistic evidence does not produce knowledge. The experiments instead suggest that people deny knowledge because they distrust drawing conclusions about an individual based on reasoning about the population to which it belongs, a tendency previously identified by “judgment and decision making” researchers. Consistent with this, participants were more willing to ascribe knowledge for beliefs based on probabilistic evidence that is specific to a particular case (Experiments 3A and 3B).     

What Determines Visual Statistical Learning Performance? Insights From Information Theory

In order to extract the regularities underlying a continuous sensory input, the individual elements constituting the stream have to be encoded and their transitional probabilities (TPs) should be learned. This suggests that variance in statistical learning (SL) performance reflects efficiency in encoding representations as well as efficiency in detecting their statistical properties. These processes have been taken to be independent and temporally modular, where first, elements in the stream are encoded into internal representations, and then the co‐occurrences between them are computed and registered. Here, we entertain a novel hypothesis that one unifying construct—the rate of information in the sensory input—explains learning performance. This theoretical approach merges processes related to encoding of events and those related to learning their regularities into a single computational principle. We present data from two large‐scale experiments with over 800 participants tested in support for this hypothesis, showing that rate of information in a visual stream clearly predicts SL performance, and that similar rate of information values leads to similar SL performance. We discuss the implications for SL theory and its relation to regularity learning.     

Learning to Neighbor? Service-learning in Context

Service-learning has received a great deal of attention in the management education literature over the past decade, as a method by which students can acquire moral and civic values as well as gain academic knowledge and practice real-world skills. Scholars focus on student and community impact, curricular design, and rationale. However, the educational environment (“context”) in which service-learning occurs has been given less attention, although experienced educators know that the classroom is hardly a vacuum and that students learn a great deal from the non-curricular aspects of their educational experience. Moral values in particular are conveyed by what is not said. Given this, I argue that the contexts in which service-learning takes place are as important as the activity itself. Three perspectives on context will be described and assessed: the “hidden” curriculum, the educational atmosphere, and the university’s orientation towards social responsibility.

Is There a Philosophy of Information?

In 2002, Luciano Floridi published a paper called What is the Philosophy of Information?, where he argues for a new paradigm in philosophical research. To what extent should his proposal be accepted? Is the Philosophy of Information actually a new paradigm, in the Kuhninan sense, in Philosophy? Or is it only a new branch of Epistemology? In our discussion we will argue in defense of Floridi’s proposal. We believe that Philosophy of Information has the types of features had by other areas already acknowledge as authentic in Philosophy. By way of an analogical argument we will argue that since Philosophy of Information has its own topics, method and problems it would be counter-intuitive not to accept it as a new philosophical area. To strengthen our position we present and discuss main topics of Philosophy of Information.     

What is the Philosophy of Information?

Computational and information-theoretic research in philosophy has become increasingly fertile and pervasive, giving rise to a wealth of interesting results. In consequence, a new and vitally important field has emerged, the philosophy of information (PI). This essay is the first attempt to analyse the nature of PI systematically. PI is defined as the philosophical field concerned with the critical investigation of the conceptual nature and basic principles of information, including its dynamics, utilisation, and sciences, and the elaboration and application of information-theoretic and computational methodologies to philosophical problems. I argue that PI is a mature discipline for three reasons: it represents an autonomous field of research; it provides an innovative approach to both traditional and new philosophical topics; and it can stand beside other branches of philosophy, offering a systematic treatment of the conceptual foundations of the world of information and the information society.     

Sexual Health Information Networks: What are Urban African American Youth Learning?

This qualitative study examined sexual health information networks among urban African American youth living in low-income communities. The authors identified sources, message content, and utility of messages about sex and sexual health in a sample of 15-17-year olds (N = 81). Youth received sexual health information from a variety of sources. Messages from parents and sex education had high utility, whereas messages from the Internet and religion had low utility. Four information network patterns were identified, suggesting considerable variation in how youth are socialized regarding sex. Findings suggest that sexual information networks have the potential to affect sexual health and development.     

Refocusing on the Learning in “Integration of Faith and Learning"

The purpose of this study was to assess student perceptions of the faith-learning integration process in instructional methods courses taught by a single professor. Thirty-one students were asked by the professor to complete an open-ended questionnaire at the end of their course experience. Results indicated that students in this study described or defined the integration of faith and learning in ways reflective of the content of the courses, which was teaching methods. While not all students said integration of faith and learning occurred in the classes, all students did provide examples of integrative moments. Most students described faith-learning integration in terms of teacher actions rather than student actions. Thus, it appears that these students were describing integration of faith and teaching more so than integration of faith and learning.