Introducing the living with illness group: A specialized treatment for patients with chronic schizophrenic conditions

This paper introduces a specialized psychotherapy/psychoeducational group treatment for patients with chronic psychotic symptoms who receive only partial benefit from psychotropic medications, psychotherapy, and milieu/activities therapy. The goal of the group is to assist patients to accurately identify the feelings, thoughts, and behaviors that are dysfunctional symptoms of their disability and then use the functional aspects of their brain as well as learned coping strategies to compensate for their disability. The group format, philosophy, procedures, and typical topics of discussion are detailed.The authors would like to thank Bruce Levine, Ph.D., and Terry Fujeoko, Ph.D., for their assistance with the initial formation of the group. Mr. Howe and Dr. Fujeoko originated the Living with Illness group and began the first group in 1985 at Waterbury Hospital Health Center, Waterbury, CT.     

Symptom and substance use reporting consistency over two years for offspring at high and low risk for depression

We examined 2-year recall of reports of lifetime symptomatology and substance use questions on the K-SADS-E in a sample of offspring at high and low risk for depression. Comparisons were made between those who forgot and those who remembered reports of screening symptoms made at the initial interview. In general, recall for symptoms of internalizing disorders (depression and anxiety disorder) was much worse than recall for symptoms of externalizing disorders (conduct disorder and substance use). Less than two-thirds of those initially meeting the lifetime depression screening criteria provided reports which met the lifetime screening criteria at followup. Significant correlates of screening criteria recall included the following variables (measured at the initial interview): history of treatment for any disorder, impairment on the GAS (a score less than 61), and the presence of hypersomnia and suicidal symptoms (thoughts or ideation). Logistic regression suggested that a prior report of suicidal symptoms (including thoughts, ideation, or behavior) was the most important correlate of screen recall.This research was supported in part by grants from the National Institute on Drug Abuse (grant R29DA07995), the National Institute of Mental Health (grant P50MH43878-03) and from the University of Illinois Campus Research Board. The authors would like to thank Dr. Myrna Weissman for making the data available and acknowledge the data analytic assistance provided by Yanchun Xu.     

The effect of Velten's mood-induction procedure for depression on hand movement and head-down posture

The purpose of the present study was to extend the behavioral criteria of Velten's mood-induction procedure for depression. Nonverbal behaviors (hand movements and head-down position) associated with clinical depression were measured both before and after a subject read either negative self-referential statements (N=14) or neutral statements (N=12). The measures were unobtrusively obtained by video recordings of the subject's behavior during a standardized interview with an experimenter. The reading of negative self-referential statements led to a significant decrease in the use of hand illustrators and a marginal increase in the use of head-down postures. No significant changes occurred in the control group. The results support the notion that Velten's procedure for depression does alter behavior in a manner similar to the clinical state of depression.This study was conducted as a senior research project at Franklin & Marshall College by the second author under the supervision of the first author.     

The Nature of Conversational Involvement and Nonverbal Encoding Patterns

Conversational involvement refers to the degree to which participants in a communicative exchange are cognitively and behaviorially engaged in the topic, relationship, and/or situation. It is argued that involvement should be viewed from a functional perspective and conceptualized as entailing fiue dimensions: immediacy, expressiveness, interaction management, altercentrism, and social anxiety. Specific nonverbal behaviors that are actually encoded to express involvement along these five dimensions are examined within an interview context. Unacquainted dyads (N=52) engaged in baseline interviews followed by a second interview in which one participant was asked to increase or decrease involvement significantly. Tiuentyone kinesic, proxemic, and vocalic behaviors were rated during five intervals. Change scores from baseline to manipulations shouted numerous differences between high and low involvement, as did correlations between magnitude of involvement and nonverbal behaviors. The behaviors that most strongly discriminated high from low involvement were general kinesic/proxemic attentiveness, forward lean, relaxed laughter, coordinated speech, fewer silences and latencies, and fewer object manipulations. Behaviors most predictive of magnitude of involvement change were facial animation, vocal warmth/interest, deeper pitch, less random movement, and more vocal attentiveness.     

The ecological assessment of an autistic child

The behavior of an autistic child was observed in his natural environment. Observations were made in three settings, over approximately 6 months. Sixteen behaviors of the child and six behaviors of adults and peers were recorded. A cluster analysis was performed to identify response classes within the behavioral structure of the child and to see if correlations existed between response and stimulus events. To examine intra- and intersetting changes, Spearman rank correlations and ttests were also computed. This autistic child exhibited a diversity of behavior over time in a given setting and across settings. He persistently ignored other nonautistic children, although he was responsive to adults. Response classes reflected an inverse correlation between the child's selfstimulatory behaviors and his attentiveness to the environment. Elevated levels of adult attention were consistently related to reduced levels in most self-stimulatory behaviors. Two response classes showed inverse relationships between self-stimulatory behaviors. Reducing the frequency of some self-stimulatory behaviors might cause increases in others.This study is based on a dissertation submitted by the first author to The University of Tennessee in partial fulfillment of the requirements for the Ph.D. degree. The research was conducted under the chairmanship of the second author. The authors wish to express their appreciation to Dr. Edward E. Cureton for his help with the statistical analyses.     

动机与情境对不同自控水平儿童学业求助的影响

本实验以小学儿童为被试,研究了在不同动机取向和情境条件下的不同自我控制水平儿童的学业求助行为。结果表明：（１）单独无自尊压力的解难题情境比群体压力情境导致更多的求助行为。（２）低自控儿童比高自控儿童产生更多的执行性求助,但主要表现在单独无自尊压力的情境下。（３）在群体压力情境下,自我卷入的儿童比任务卷入的儿童表现出更多的求助行为。（４）在单独无自尊压力的情境下,任务卷入的儿童比自我卷入的儿童表现出     

Innovative knowledge Utilization through information transfer: A new relationship between libraries and user organizations

In our rapidly changing environment, both profit and non-profit organizations confront an increasing demand for technological, economic, and social innovation. In response to this demand, organizations are taking on the role of “change agents” by transforming existing practices into innovative action. Libraries, as centers that accumulate and disperse knowledge, can support these organizations in their “change agent” roles. This paper delineates the way public libraries can help organizations meet the increasing need for external information associated with innovation. Policy issues concerned with efficient information transfer to user organizationss are specified, and two concrete examples of information transfer systems are described. In order to best utilize existing knowledge,personal-professional assistance in selecting potentially innovative,impersonal written materials is recommended. Dr. Celeste P. M. Wilderom is an assistant professor at the School of Economics of the Free University of Amsterdam, The Netherlands and a research associate in organization behavior at the School of Management, S.U.N.Y., Buffalo. NY 14260. Her Ph.D. is in organizational psychology from S.U.N.Y., Buffalo, Where she taught in the Schools of Management and Social Work. Dr. Wilderom's research interests are behaviors in service and nonprofit organizations, problems of cross-cultural managemet and educational issues in the social sciences.     

Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.)

This study tested the effectiveness of an existing private online CBT-based group intervention designed to help people with hoarding. Web-group participants were hypothesized to show more improvement in hoarding symptoms over time compared to those placed on a naturalistic waitlist. This web-based self-help group (N = 106 members, N = 155 waitlisted) includes a formal application process and requires that participants post action steps and progress at least once monthly. Members have access to educational resources on hoarding, cognitive strategies, and a chat-group. Potential research participants were invited to complete an anonymous web-based survey about their hoarding behaviors and clinical improvement on five occasions (3 months apart). The sample was mainly middle-aged, female and White. Regression analyses show that Recent members reported greater improvement and less clutter at 6 months (than Waitlist). Long-term members reported milder hoarding symptoms than Recent ones, suggesting benefits from group participation over time. All members showed reductions in clutter and hoarding symptoms over 15 months. Less posting activity was associated with greater hoarding severity. Online CBT-based self-help for hoarding appears to be a promising intervention strategy that may extend access to treatment. Evaluating the benefits of internet self-help groups is critical given growing popularity of and demand for web-based interventions.     

Internet‐Based Self‐Help Versus One‐Session Exposure in the Treatment of Spider Phobia: A Randomized Controlled Trial

The authors compared guided Internet‐delivered self‐help with one session of live‐exposure treatment in a sample of spider‐phobic patients. A total of 30 patients were included following screening on the Internet and a structured clinical interview. The Internet treatment consisted of five weekly text modules, which were presented on a web page, a video in which exposure was modelled, and support provided via Internet. The live‐exposure treatment was delivered in a 3‐hr session following a brief orientation session. The main outcome measure was the behavioural approach test (BAT), and as secondary measures the authors used questionnaires measuring anxiety symptoms and depression. Results showed that the groups did not differ at posttreatment or follow‐up, with the exception of the proportion showing clinically significant change on the BAT. At posttreatment 46.2% of the Internet group and 85.7% in the live‐exposure group achieved this change. At follow‐up the corresponding figures were 66.7% for the Internet group and 72.7% for the live treatment. Within‐group effect sizes for the spider phobia questionnaire were large (d = 1.84 and 2.58 for the Internet and live‐exposure groups, respectively, at posttreatment). The authors conclude that guided Internet‐delivered exposure treatment is a promising new approach in the treatment of spider phobia.     

Physical recovery in Arthroscopic knee surgery: unique contributions of coping behaviors to clinical outcomes and stress reactivity

Few studies have examined whether certain coping behaviors are associated with physical outcomes following surgery. This prospective, longitudinal study investigated the effect of active and avoidant coping behaviors on two physical outcomes over time, pain and knee function, in a group of patients experiencing knee arthroscopic surgery (n = 81). Structured interviews and physician clinical assessments were conducted preoperatively and at 3 and 24 weeks postoperatively. Coping behavior was assessed during the preoperative interview, and patients were divided into high and low avoidant and active coping groups. Using repeated measures MANCOVA/ANCOVA, avoidant coping was significantly associated with knee pain and active coping was associated with knee function. Serum cortisol levels were available for a patient subset (n = 16); higher cortisol was related to both avoidant coping and poorer functioning during early recovery. Results suggest that these divergent coping behaviors are differentially associated with stress reactivity and physical outcomes in healthy patients undergoing minor knee surgery.     

Investigation of nonverbal discrimination against women in simulated initial job interviews

This study investigated nonverbal sex discrimination in simulated initial job interviews with women applicants. It was hypothesized that experienced interviewers would exhibit more negative behaviors while interviewing a woman for a “masculine” job (an incongruent interview), but more positive behaviors while interviewing a woman for a “feminine” job (a congruent interview). It was further hypothesized that the behavior of inexperienced interviewers would remain the same across interviews. Mock initial job interviews were videotaped and nonverbal behaviors were coded. As hypothesized, experienced interviewers exhibited more negative and fewer positive behaviors in the incongruent interviews, whereas inexperienced interviewers did not. Unexpectedly, inexperienced interviewers exhibited more positive and fewer negative behaviors during incongruent interviews. Implications for training to reduce nonverbal discrimination are discussed.     

Post-Traumatic Stress Disorder Symptoms of Children Following the Occurrence of Tehran City Park Disaster

The authors investigated the post-traumatic stress disorder (PTSD) symptoms of young adolescents who had been directly involved in a disaster in Tehran. The participants were 19 chlidren who had survived a boat sinking in Tehran's city park in 2002. By using the Post-Traumatic Stress Disorder Symptom Scale (PSS; E. B. Foa, D. S. Riggs, C. V. Dancu, & B. O. Rothbaum, 1993) as well as a clinical interview based on the definition cited in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994, p. 424), 16 participants (84.2%) were diagnosed with PTSD using the PSS and 17 (89.5%) were diagnosed with PTSD using the psychiatric interview.     

Sexual and Physical Abuse Among Adolescent Girls with Disruptive Behavior Problems

We examined the prevalence and age of onset of physical and sexual abuse in a clinic-referred sample of adolescent girls, as well as differences in diagnoses and symptoms among abused and non-abused girls. Forty-nine girls (aged 13–17 years) with disruptive behavior were interviewed along with their primary caretaker. Data were gathered through both a structured interview with the girl and her parent, as well as self and parent-report questionnaires. Findings indicated that the prevalence of Conduct Disorder (CD) and Major Depression were higher for abused girls. Somatoform Pain Disorder was significantly less likely for physically abused girls, compared to girls who were both physically and sexually abused. Of CD symptoms, truancy was twice as high for the physically and sexually abused group, compared to the prevalence for non-abused girls. Internalizing symptoms were also highest for the dual abuse group. Onset graphs show that the onset of sexual abuse usually occurred at an earlier age than the onset of physical abuse. Abused girls showed an earlier age of onset of CD symptoms. Results indicated that the experience of combined types of abuse is associated with a poorer psychiatric prognosis.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

Observed behaviors during clinical interviews predict improvement in depression

A considerable percentage of depressed patients do not respond to antidepressive treatment. Early indicators of prognosis are needed. The aims of this study are to examine (a) whether the interpersonal behavior of patients and psychiatrist, as assessed by means of direct observation of behavior during a baseline clinical interview, might have predictive value with respect to therapeutic outcome and (b) which predictive potency measures of psychomotor activation, as assessed by less refined methods, such as global clinical judgment, might have. In the analysis used, speech-pause behavior was taken as the basic structure of the interaction. The relations of other behaviors such as looking and hand and head movement with this structure were determined. Evidence is presented that in a group of 31 depressives, improvement after a period of 10 weeks was related to observed behaviors during a baseline interview. The behaviors of the patients are interpreted as relational or nonrelational. The relational behaviors (i.e., looking yesnodding, gesturing) occur less in patients who will improve, whereas the nonrelational behaviors (i.e., intensive body touching, head movements) occur more in these patients. The nonrelational behaviors are presumed to be indicative of the state of arousal. The predictive potency of these variables could not be explained by their relationship with the baseline severity of depression, which in itself also predicted improvement. Moreover, global clinical assessment of psychomotor activation (i.e., retardation and agitation) could not be related to outcome.     

Transition to the Clinical Doctorate: Attitudes of the Genetic Counseling Training Program Directors in North America

In North America, genetic counseling is an allied health profession where entry level practitioners currently must hold a master’s degree earned from a graduate program accredited by the American Board of Genetic Counseling. This is one of many health care professions that could transition to an entry level clinical doctorate degree. This study explored the attitudes of genetic counseling training program directors toward such a transition. Thirty-one North American program directors were invited to complete an online survey and a follow-up telephone interview. Twenty-one program directors completed the survey and ten directors also completed a follow up phone interview. There was disagreement among the respondents on the issue of transitioning to a clinical doctorate degree (nine in favor, six against and six undecided). Respondents disagreed about whether the transition would lead to higher salaries (six yes, eight no, and seven unsure) or increased professional recognition (eight yes, eight no, and four unsure). Approximately half (n = 10) of directors were not sure if the transition to a clinical doctorate would help or hurt minority recruitment; six thought it would help and four thought it would hurt. However, the majority (n = 13) thought a clinical doctorate would help genetic counselors to obtain faculty positions. If the field transitions to a clinical doctorate, 11 of the directors thought their program would convert, seven were unsure and one thought their program would shut down. Themes identified in interview data included 1) implications for the profession 2) institution-specific considerations and 3) perception of the unknown. Opinions are quite varied at this time regarding the possible transition to the clinical doctorate among genetic counseling training program directors.     

Giving and Receiving Help: Interpersonal Transactions in Mutual-Help Meetings and Psychosocial Adjustment of Members

The helping transactions that occur in group meetings have been theorized to be important therapeutic mechanisms within mutual-help (or self-help) groups. Hypothesized links between giving and receiving help and psychosocial adjustment were examined in a mutual-help group for individuals with serious mental illness (GROW). Participants' adjustment was assessed at two time points and helping behaviors were measured with observational coding of weekly group interactions during the period between assessments. Frequencies of helping behaviors were used to predict Time 2 adjustment after controlling for initial adjustment. Consistent with the helper therapy principle, giving help to others predicted improvements in psychosocial adjustment; giving advice was a unique predictor. Total amount of help received was not associated with adjustment, but receiving help that provided cognitive reframing was associated with better social adjustment. A predicted interaction suggested that receiving help was related to better functioning when members experienced high levels of group integration.     

Client characteristics associated with behavior change for treated and untreated aggressive boys

This study examined the relationship between subject characteristics of aggressive boys and their behavioral changes during a school year. Seventy-six boys in the fourth, fifth, and sixth grades were identified by their teachers as the most disruptive and aggressive in their classes. These boys were assigned to untreated control, anger-coping, anger-coping plus goal-setting treatment, and minimal treatment goal-setting cells. The anger-coping treatment was based on cognitive behavioral procedures. In both anger-coping cells, greater reductions in rates of disruptive/aggressive off-task classroom behavior was predicted by having higher rates of these behaviors initially, and greater reductions in parents' ratings of aggression was predicted by having poor social problem-solving skills initially. Additional predictors of reductions in parents' ratings of aggression in one, but not both, anger-coping cells included having higher rates of somatic symptoms and poorer social acceptance by peers. In contrast to the other cells, those boys in the no-treatment group who demonstrated the greatest spontaneous improvement on these change measures were the ones who initially were the best problem-solvers and who had higher levels of self-esteem. This cognitive-behavioral treatment appeared to have most impact with those boys who were the most in need of intervention.Portions of this paper were presented at the American Psychological Association annual convention, Anaheim, California, August 1983. Acknowledgment is made of the administrative and/or financial support provided by the Durham County School System, the Duke University Medical Center Department of Psychiatry, and the Durham Community Guidance Clinic. Appreciation is expressed to the other coleaders of the groups: Rosalyn Alexander, Steve Harris, Pat Kirkley, Val McLean, Kathy McSwain, Connie Scott, Barbara Thornton, Mary Ann Black, Harvey Botman, Dr. Bonnie Gregory, and Dr. Renee Schoenfeld.