Feedback in Couple and Family Therapy: A Randomized Clinical Trial

Routine Outcome Monitoring (ROM) is recommended as a psychotherapy procedure to serve as clinical feedback in order to improve client treatment outcomes. ROM can work as a warning signal to the therapist if the client shows signs of no change or deterioration. This study has investigated whether any difference in outcome could be detected between those clients in couple and family therapy who used the Systemic Therapy Inventory of Change (STIC) feedback system (ROM condition) versus those who were offered treatment without the use of STIC (“treatment as usual” or TAU condition). A sample of 328 adults seeking couple and family therapy in Norway was randomly assigned to ROM versus TAU conditions. Outcome measures were The Outcome Questionnaire–45 and The Revised Dyadic Adjustment Scale. The results demonstrated no significant differences in outcomes between the ROM and TAU. Possible explanations of this result related to design and implementation issues are discussed.     

建设本土化的工程心理学

本文论述了三个问题 :1把 3 0年来我国工程心理学的发展分为三个阶段 :60年代前期为初兴期 ;70年代中期至 80年代初为恢复期 ;80年代中期开始为发展期。2阐明建设中国本土化工程心理学的意义 ,并提出工程心理学本土化的标准。3强调只有加强应用研究 ,才能加速建立适合我国国情的工程心理学。     

Contributions of Psychophysiology to Media Research: Review and Recommendations

Despite the increasing use of psychophysiological measures in various research areas, there is a relative paucity of studies on communication, media, and media interfaces that have taken advantage of this approach. This article provides an overview of the use of psychophysiological measures of attention and emotion in media research with the focus on 3 most commonly used measures: heart rate, facial electromyography, and electrodermal activity. Selected media studies that have used psychophysiological methods to test theory-based predictions regarding the role of attentional and emotional factors in message processing are critically reviewed. The article also highlights some methodological and other issues critical for the successful application of psychophysiological methods to problems in media research. In particular, respiratory sinus arrhythmia (RSA), a selective index of parasympathetic nervous system activity, is introduced as a measure that holds particular promise for media research, given that RSA is highly sensitive to changes in attention.     

An open-source LabVIEW application toolkit for phasic heart rate analysis in psychophysiological research.

The cardiovascular system has been extensively measured in a variety of research and clinical domains. Despite technological and methodological advances in cardiovascular science, the analysis and evaluation of phasic changes in heart rate persists as a way to assess numerous psychological concomitants. Some researchers, however, have pointed to constraints on data analysis when evaluating cardiac activity indexed by heart rate or heart period. Thus, an off-line application toolkit for heart rate analysis is presented. The program, written with National Instruments' LabVIEW, incorporates a variety of tools for off-line extraction and analysis of heart rate data. Current methods and issues concerning heart rate analysis are highlighted, and how the toolkit provides a flexible environment to ameliorate common problems that typically lead to trial rejection is discussed. Source code for this program may be downloaded from the Psychonomic Society Web archive at www.psychonomic.org/archive/.     

An open-source LabVIEW application toolkit for phasic heart rate analysis in psychophysiological research

The cardiovascular system has been extensively measured in a variety of research and clinical domains. Despite technological and methodological advances in cardiovascular science, the analysis and evaluation of phasic changes in heart rate persists as a way to assess numerous psychological concomitants. Some researchers, however, have pointed to constraints on data analysis when evaluating cardiac activity indexed by heart rate or heart period. Thus, an off-line application toolkit for heart rate analysis is presented. The program, written with National Instruments’ LabVIEW, incorporates a variety of tools for off-line extraction and analysis of heart rate data. Current methods and issues concerning heart rate analysis are highlighted, and how the toolkit provides a flexible environment to ameliorate common problems that typically lead to trial rejection is discussed. Source code for this program may be downloaded from the Psychonomic Society Web archive atwww.psychonomic.org/archive/.     

Sleep disturbances in the aftermath of trauma and posttraumatic stress disorder

Sleep disturbances, including nightmares and insomnia, are prominent following trauma and with posttraumatic stress disorder (PTSD) and likely contribute to the pathogenesis of the disorder. Findings from laboratory studies of PTSD have been inconsistent in terms of documenting objective impaired sleep maintenance but have been somewhat more consistent in indicating alterations of rapid eye movement (REM) sleep. Studies of the early aftermath of trauma can reduce the complexity associated with chronicity and comorbidity, and may have implications for early diagnosis and prevention. Multiple studies indicate that dream content is affected by recent threatening experiences. The development of PTSD is associated with a more replicative type of nightmare content. Sleep is reported to be generally disrupted following trauma especially among those developing PTSD. The limited number of studies that provide objective recorded indices during the early aftermath of trauma also provide a mixed picture regarding overall sleep maintenance. Recent data suggest that a more specific disruption of REM sleep may be associated with the development of PTSD and that this disruption is associated with an increased signal of sympathetic nervous system activation during REM sleep. Disrupted REM sleep and increased sympathetic/noradrenergic activity may have implications for understanding recent promising interventions for PTSD sleep disturbance that can be applied to early intervention.     

The construction of career through goal-directed action

The thesis of this article is that occupational career is constructed through a system of intentional, goal-directed processes in the form of actions and projects as well as other careers, such as the family career and relationship careers. A contextual action theory of career is proposed as an approach that reflects a constructionist stance and at the same time addresses fundamental issues raised by social constructionism, such as issues of meaning, interpretation, and agency. The discussion is illustrated by reference to a research program on the family career-development project that examines the joint action of parents and adolescents relative to the adolescent’s future. It is further suggested that this approach leads constructionism beyond its epistemological critique to a positive formulation of professional and everyday activity.     

Search activity in the context of psychosomatic disturbances,of brain monoamines and REM sleep function

The author discusses a number of controversial aspects of the search activity concept. This concept, based on an analysis of data cited by other researchers and the results of the author’s own investigation, performed together with V. V. Arshavsky, postulates that search activity raises the body’s resistance to stress and experimentally induced pathology whereas renunciation of search forms a nonspecific predisposition to somatic disturbances (e.g., psychosomatic disease). REM sleep is regarded as a specific form of search activity aimed at compensating for the state of renunciation of search in walking. In this paper the author argues that 1) renunciation of search can be accompanied either by anxiety or by depression, 2) REM sleep deprivation on a “small platform” raises the requirement in REM sleep by producing renunciation of search, 3) during search activity brain catecholamine synthesis is stimulated by catabolism whereas a state of renunciation of search upsets this feedback system. The actuation of the brain mechanisms of search in REM sleep necessitates a certain brain catecholamine level. If the brain catecholamine level is very high during waking behavior due to intensive search activity, the REM sleep requirement is low, REM sleep becoming reduced. After a moderate drop in the brain catecholamine level at the initial stage of renunciation of search the requirement in REM sleep rises and this phase grows longer. But at the late stage of renunciation of search the brain catecholamine level drops extremely, REM sleep shrinking in spite of the great appropriate requirement, and 4) the functional insufficiency of REM sleep invites various forms of pathology.     

Community psychology values and the culture of graduate training: A self-study

In this self-study of an M.A. program in community psychology, the authors focused on evaluation of training goals related to the values of collaboration, empowerment, and diversity. Employing quantitative and qualitative methods, the evaluator, a thesis student in the program, cooperated with a stakeholder committee and other student, staff, and faculty members of the program to construct the methods and interpret the findings. Although the converging sources of data showed that the program was meeting its process goals to some extent, several key issues in the culture of training, such as the status of women, the psychological sense of community, and a supportive learning environment, needed improvement. The authors interpret the findings in terms of the impact of the university system and patriarchal norms on training in community psychology. This study is based on the first author's M.A. thesis, which the second author supervised. Judit Alcalde works in health promotion with the Regional Municipality of Waterloo, Community Health Department. She presented an earlier version of this work at the conference of the Canadian Psychological Association, Calgary, Alberta, June 1991. We are grateful to the thesis committee members for their support and guidance, to our colleagues for their participation, to Paul Davock, and to the reviewers and editor for their helpful comments.     

Automatic recognition of sleep spindles using short-term spectral analysis

An approach tö recognize automatically sleep spindles by using short-term spectral analysis is described. The EEG signal is sampled and stored on a magnetic tape in digital form. The data is analyzed on a PDP-8 computer, and the result can be either displayed on an oscilloscope or stored on another magnetic tape for further analysis. The program is written in conversational form and provides the operator with the ability to change any parameter in the program quickly by a simple command on the Teletype keyboard.     

THE BEHAVIOR OBSERVATION INSTRUMENT: A METHOD OF DIRECT OBSERVATION FOR PROGRAM EVALUATION1

The background and development of a multicategory direct observation system, the Behavior Observation Instrument (BOI), is described. This time-sampling procedure for recording the behavior of persons is demonstrated in several treatment settings and the results applied to issues of program evaluation. Elements that have prevented direct observation from being widely adopted, such as costs, manpower, and training requirements, are systematically analyzed. A basic psychometric analysis of the instrument is used to determine optimum frequency and duration of observation intervals as well as observer agreement. The results imply that direct observation methods, once assumed by some to belong to the special province of the single-subject design, can be used to assess the effects of programs on groups of psychiatric clients in an efficient and economic manner.     

Ecological interventions and the process of change for prevention: Wedding theory and research to implementation in real world settings

Considers a preventive intervention effort designed to modify the characteristics and regularities of the school environment so as to enhance the expectations conveyed to high risk students. Employing this case effort (Weinstein et al., 1991) as a base, several issues are highlighted that deserve greater attention in the design, implementation, assessment, and reporting of other preventively-focused social interventions. These issues include: (1) the degree of program implementation fidelity, (2) the impact a lack of attainment of program fidelity may have on arriving at erroneous evaluation conclusions about social programs, (3) the ways in which the theory and basic research employed in the program rationale is appropriate to and reflected in the program as designed, (4) issues of program potency and dosage, (5) the ways in which quantitative and qualitative evaluation data can enhance each other, and (6) the import of evaluability assessments of programs prior to moving to outcome evaluations. In addressing these issues, the importance of developmentally- and ecologically-informed program formulations is underscored. Finally, the critical role that program reports such as the Weinstein paper, with its careful discussion of both the process of implementation and outcome assessments, can play in the development of more effective prevention program implementation efforts is highlighted.     

Adapting Brief CBT-I for Depressed Adolescents: A Case Illustration of the Sleeping Better Program

Disturbed sleep is a common symptom of depression in adolescents, but this symptom is not often targeted in psychological therapies for depression. Although the causal relationship between sleep and depression is unclear, there is increasing evidence that in adults, Cognitive Behavioral Therapy for Insomnia (CBT-I) improves sleep problems and reduces symptoms of depression; however, there has been little investigation of using this approach with adolescents. This article describes the adaptation of brief CBT-I for adolescents with depression. A single case study is reported to illustrate the use of the Sleeping Better program. Adaptations for adolescents include increased emphasis on engagement of the young person and the inclusion of parents in treatment. The treatment program was acceptable to the adolescent and parent, and treatment outcome, as indicated by sleep diaries and standardized measures of depression and anxiety, was positive. Further evaluation of the Sleeping Better program is needed to establish if it is an effective low-intensity intervention for sleep problems in adolescents who have depression or anxiety.     

A daytime nap enhances visual working memory performance and alters event-related delay activity

Working memory (WM) is impaired following sleep loss and may be improved after a nap. The goal of the current study was to better understand sleep-related WM enhancement by: (1) employing a WM task that assesses the ability to hold and report visual representations as well as the fidelity of the reports on a fine scale, (2) investigating neurophysiological properties of sleep and WM capacity as potential predictors or moderators of sleep-related enhancement, and (3) exploring frontal and occipital event-related delay activity to index the neural processing of stimuli in WM. In a within-subjects design, 36 young adults (M_age = 20, 20 men, 16 women) completed a 300-trial, continuous-report task of visual WM following a 90-min nap opportunity and an equivalent period of wakefulness. Mixed-effect models were used to estimate the odds of successful WM reports and the fidelity of those reports. The odds of a successful report were approximately equal between nap and wake conditions for the start of the task, but by the end, the odds of success were 1.26 times greater in the nap condition. Successful WM reports were more accurate after a nap, independent of the time on task. Neither WM capacity nor any of the sleep variables measured were found to significantly moderate the nap effect on WM. Lastly, napping resulted in amplitude changes for frontal and occipital delay activity relative to the wake condition. The findings are discussed in relation to contemporary models of visual WM and the role of sleep in sustained attention.     

Some supplementary methods for the analysis of the Delis-Kaplan Executive Function System

Supplementary methods for the analysis of the Delis-Kaplan Executive Function System (Delis, Kaplan, & Kramer, 2001) are made available, including (a) quantifying the number of abnormally low achievement scores exhibited by an individual and accompanying this with an estimate of the percentage of the normative population expected to exhibit at least this number of low scores; (b) estimating the overall abnormality of an individual's achievement score profile with the Mahalanobis distance index; (c) calculating a composite executive function index score for an individual and providing accompanying confidence limits; and (d) providing the percentile ranks for an individual's achievement scores and executive index score (in the latter case, confidence limits on scores are also expressed as percentile ranks). With the exception of the Mahalanobis distance index, all the methods can be obtained with the equations and tables provided in this article. However, for the convenience of clinicians and to reduce the possibility of clerical error, the methods have also been implemented in a computer program. More important, the program allows the methods to be applied when only a subset of scores is available. The program can be downloaded (as a zip file) from this article's supplemental materials or from www.abdn.ac.uk/~psy086/dept/DKEFS_Supplementary_Analysis.htm.     

Poor recall of eye-movement signals from Stage 2 compared to REM sleep: implications for models of dreaming

An ongoing assumption made by sleep researchers is that since dreams are more often recalled on awakening from rapid eye movement (REM) sleep, dreams must occur more often during this stage of sleep. An alternative hypothesis is that cognition occurs throughout sleep, but the recall of this mentation differs on awakening. When a dream is not reported on awakening, there is no method of establishing whether it did not happen or was forgotten. The aim of the present study was to investigate this issue using an eye movement (EM) signal verification technique. Participants were instructed to produce an EM signal whenever they heard a tone. Tones were presented at increasing volume during Stage 2 and REM sleep until EM signal verification was observed. Ninety seconds after signal verification, participants were awakened and asked if they remembered hearing the tone or responding with the EM signal. Such recollection of signal verified tone (SVT) presentations was significantly less after Stage 2 sleep (65%) compared to REM sleep (100%) presentations. Furthermore, SVT recall was significantly correlated with reported dream recall frequency, suggesting the same processes involved in recalling SVTs might also underlie dream recall.     

Raising Suspicions with the Food and Drug Administration: Detecting Misconduct

The clinical Bioresearch Monitoring (BIMO) oversight program of the US Food and Drug Administration (FDA) assesses the quality and integrity of data submitted to the FDA for new product approvals and human subjects protection during clinical studies. A comprehensive program of on-site inspections and data verification, the BIMO program routinely performs random inspections to verify studies submitted to the FDA to support a marketing application. On occasion the FDA will conduct a directed inspection of a specific site or study to look for problems that may have previously been identified. The inspection of a clinical study sometimes uncovers evidence of research fraud or misconduct and it must be decided how to deal with the investigator and the suspect data. The prevention of [or] decreasing the incidence of fraud and misconduct through monitoring by the sponsor is one way to manage compliance issues and can help prevent misconduct. A training program is another way to manage compliance issues in clinical research. While training does not guarantee quality, it does help to ensure that all individuals involved understand the rules and the consequences of research misconduct.     

Sensorimotor EEG operant conditioning: Experimental and clinical effects

Neurophysiological studies in cats have established a functional relationship between waking 12–15 Hz sensorimotor cortex rhythmic EEG activity (the sensorimotor rhythm or SMR) and a similar pattern during sleep, the sleep spindle. Both result from oscillatory thalamocortical discharge involving ventrobasal thalamus and sensorimotor cortex, and both are associated with a state of suppressed motor excitability. Enhancement of the SMR with operant conditioning methods in the cat clearly led to reduced seizure susceptibility. The experimental application of this approach to seizure control in epileptics has resulted in (A) evidence that EEG patterns can be manipulated significantly in man with operant conditioning, (B) suggestive observations concerning a potential component of pathology in epilepsy, and (C) strong preliminary evidence that SMR operant conditioning in epileptics is specifically therapeutic. Current research has focused upon the EEG during sleep in epileptics with primary motor symptomatology. This measure often reveals several hard signs of pathology. These include the presence of abnormal activity in the 4–7 Hz frequency band and the absence or disturbance of activity in the 11–15 Hz frequency band. Power spectral analysis is being utilized to quantify these sleep EEG components in five groups of epileptic patients, studied with different frequency patterns rewarded in an A-B-A design which provides for counterbalancing of order effects. Initial laboratory training is followed by 9–12 months of training at home with portable feedback equipment. Reward contingencies are reversed within each group at approximately three month intervals. Clinical EEG data, blood anticonvulsant measures and patient seizure logs supplement sleep EEG data obtained before training and after each phase of the design. Early results have again indicated specific therapeutic benefits following training of high frequency rhythmic central cortical activity.     

The reciprocal relation between sleep and memory in infancy: Memory‐dependent adjustment of sleep spindles and spindle‐dependent improvement of memories

Sleep spindle activity in infants supports their formation of generalized memories during sleep, indicating that specific sleep processes affect the consolidation of memories early in life. Characteristics of sleep spindles depend on the infant's developmental state and are known to be associated with trait‐like factors such as intelligence. It is, however, largely unknown which state‐like factors affect sleep spindles in infancy. By varying infants’ wake experience in a within‐subject design, here we provide evidence for a learning‐ and memory‐dependent modulation of infant spindle activity. In a lexical‐semantic learning session before a nap, 14‐ to 16‐month‐old infants were exposed to unknown words as labels for exemplars of unknown object categories. In a memory test on the next day, generalization to novel category exemplars was tested. In a nonlearning control session preceding a nap on another day, the same infants heard known words as labels for exemplars of already known categories. Central–parietal fast sleep spindles increased after the encoding of unknown object–word pairings compared to known pairings, evidencing that an infant's spindle activity varies depending on its prior knowledge for newly encoded information. Correlations suggest that enhanced spindle activity was particularly triggered, when similar unknown pairings were not generalized immediately during encoding. The spindle increase triggered by previously not generalized object–word pairings, moreover, boosted the formation of generalized memories for these pairings. Overall, the results provide first evidence for a fine‐tuned regulation of infant sleep quality according to current consolidation requirements, which improves the infant long‐term memory for new experiences.     

The treatment of nocturnal bruxism using contingent EMG feedback with an arousal task

Nocturnal electromyographic (EMG) recordings of masseter muscle activity were performed before and after treatment on 10 heavy bruxism subjects. Treatment consisted of giving the subjects an auditory feedback signal during sleep which occurred when they clenched with moderate force. Each subject additionally had to perform an arousal task every time the signal occurred. Nine of 10 subjects demonstrated a significantly decreased EMG activity using a contingent auditory feedback signal, combining it with an arousal task.