Implicit awareness of ambiguity: a role in the development of obsessive-compulsive disorder

The cognitive-behavioral model of obsessive-compulsive disorder proposes that obsessional symptoms are the consequence of the manner in which intrusive cognitions are interpreted [e.g., Salkovskis, P. M. (1998). Cognitive-behavioral approach to understanding obsessional thinking. British Journal of Psychiatry, 173(35S), 53-63]. The present study suggests that this may be attributable to maladaptive implicit cognitive processing, a deficit that results in the explicit awareness of ambiguity in idiographic obsessive-compulsive disorder (OCD) stimuli. The present study examines decision-making responses of low and high OCD scorers in a non-clinical undergraduate sample. Via a computer console, participants were shown sentence statements for three levels of ambiguity. They were then presented with a propositional statement for which they had to indicate agreement or disagreement for sentences of varying ambiguity. After this, the participants indicated whether they were completely confident or unconfident as regards their previous agree-disagree decisions. Results indicate that the high compared to the low OCD scoring group had less agreement and subsequent less confidence in decisions made for sentences of varying ambiguity. Response latencies partially fitted the predicted hypotheses. Consequently, an addition to Salkovskis, Forester, and Richards' [1998. Cognitive-behavioral approach to understanding obsessional thinking. The British Journal of Psychiatry, 173(35S), 53-63] model of OCD is suggested: namely that an implicit ambiguity deficit mediates the likelihood of normally occurring intrusions developing into abnormal obsessions. Methodological limitations and future research are considered.     

THE MOTHERS AND TODDLERS PROGRAM, AN ATTACHMENT-BASED PARENTING INTERVENTION FOR SUBSTANCE-USING WOMEN: RESULTS AT 6-WEEK FOLLOW-UP IN A RANDOMIZED CLINICAL PILOT

Previously, we reported posttreatment findings from a randomized pilot study testing a new attachment-based parenting intervention for mothers enrolled in substance-use treatment and caring for children ages birth to 3 years (N.E. Suchman, C. DeCoste, N. Castiglioni, T. McMahon, B. Rounsaville, & L. Mayes, 2010). The Mothers and Toddlers Program (MTP) is a 12-session, weekly individual parenting therapy that aims to enhance maternal capacity for reflective functioning and soften harsh and distorted mental representations of parenting. In a randomized pilot study, 47 mothers who were enrolled in outpatient substance-abuse treatment and caring for children between birth and 3 years of age were randomized to the MTP versus the Parent Education Program (PE), a comparison intervention that provided individual case management and developmental guidance. At the end of treatment, mothers in the MTP condition demonstrated better reflective functioning, representation quality, and caregiving behavior than did mothers in the PE condition. In this investigation, we examined whether the benefits of MTP at posttreatment were sustained at the 6-week follow-up. Recently, we also identified two components of parental reflective functioning: (a) a self-focused component representing the parent's capacity to mentalize about strong personal emotions (e.g., anger, guilt, or pain) and their impact on the child and (b) a child-focused component representing the parent's capacity to mentalize about the child's emotions and their impact on the mother (N. Suchman, C. DeCoste, D. Leigh, & J. Borelli, 2010). In this study, we reexamined posttreatment outcomes using these two related, but distinct, constructs.     

Implicit sources of bias in employment interview judgments and decisions

This study empirically examined implicit sources of bias in employment interview judgments and decisions. We examined two ethnic cues, accent and name, as sources of bias that may trigger prejudicial attitudes and decisions. As predicted, there was an interaction between the applicant name and accent that affected participants’ favorable judgments of applicant characteristics. The applicant with the ethnic name, speaking with an accent, was viewed less positively by interviewers than the ethnic named applicant without an accent and non-ethnic named applicants with and without an accent. Furthermore, modern ethnicity bias had a negative association with the favorable judgments of the applicants, which, in turn, affected hiring decisions. Implications of the results, limitations of the study, and directions for future research are discussed.     

Links Between Disorganized Attachment Classification and Clinical Symptoms in School-Aged Children

Research examining the links between disorganized attachment and clinical symptoms largely has neglected middle childhood due to lack of available measurement tools. The few studies that have examined these links in other developmental phases have found higher clinical symptoms in disorganized individuals. Our study extended this research by using a recently-developed attachment interview measure ideally suited to evaluate disorganized attachment in middle childhood. We examined concurrent associations among disorganized attachment in 8–12 year old children and symptoms of psychopathology theoretically hypothesized for their links with disorganized attachment. Using child- and parent-reports, we measured symptoms of depression, social anxiety, shyness, inattention, and thought problems. During our two-session study, 97 children completed the Child Attachment Interview, and children and parents completed clinical questionnaires. Results suggested that disorganized attachment was associated with higher child reports of depressive symptoms and shyness, and with parent-reports of social anxiety, inattention, and thought problems, and that disorganized children are more likely to have symptoms that meet clinical criteria. Implications for the relation of attachment to psychopathology are discussed.     

Cross-Sectional Age Analysis of Sleep Problems in 2 to 17 Year Olds with ADHD Combined,ADHD Inattentive,or Autism

Sleep problems are common in autism and ADHD. No study has compared sleep problems by age in 2 to 17 year olds with autism versus ADHD-Combined versus ADHD-Inattentive type. Mothers rated 1415 youth with autism and 1041 with ADHD on 10 Pediatric Behavior Scale sleep items. Nighttime sleep problems were most severe in autism, followed by ADHD-Combined, and then ADHD-Inattentive. Difficulty falling asleep, restless during sleep, and waking during the night were the most common problems. Adolescents slept more at night than other age groups, and youth who slept more at night were sleepier during the day. Sleep problems declined with age, but correlations were small. In adolescence, 63% with autism, 53% with ADHD-Combined, and 57% with ADHD-Inattentive had difficulty falling asleep. Given that the majority of children in all age groups had one or more sleep problem, developmentally appropriate interventions are needed to address sleep difficulties and limit their adverse effects.

     

Development of neural systems for processing social exclusion from childhood to adolescence

Adolescence is a period of development in which peer relationships become especially important. A computer-based game (Cyberball) has been used to explore the effects of social exclusion in adolescents and adults. The current functional magnetic resonance imaging (fMRI) study used Cyberball to extend prior work to the cross-sectional study of younger children and adolescents (7 to 17 years), identifying age-related changes in the neural correlates of social exclusion across the important transition from middle childhood into adolescence. Additionally, a control task illustrated the specificity of these age-related changes for social exclusion as distinct from expectancy violation more generally. During exclusion, activation in and functional connectivity between ventrolateral prefrontal cortex and ventral anterior cingulate cortex increased with age. These effects were specific to social exclusion and did not exist for expectancy violation. Our results illustrate developmental changes from middle childhood through adolescence in both affective and regulatory brain regions during social exclusion.