Homework Completion,Patient Characteristics,and Symptom Change in Cognitive Processing Therapy for PTSD

We evaluated the impact of homework completion on change in PTSD symptoms in the context of two randomized controlled trials of Cognitive Processing Therapy for PTSD (CPT). Female participants (n = 140) diagnosed with PTSD attended at least one CPT session and were assigned homework at each session. The frequency of homework completion was assessed at the beginning of each session and PTSD symptoms were assessed every other session. Piecewise growth models were used to examine the relationship between homework completion and symptom change. CPT version (with vs without the written trauma account) did not moderate associations between homework engagement and outcomes. Greater pretreatment PTSD symptoms predicted more Session 1 homework completion, but PTSD symptoms did not predict homework completion at other timepoints. More homework completion after Sessions 2 and 3 was associated with less change in PTSD from Session 2 to Session 4, but larger pre-to-post treatment changes in PTSD. Homework completion after Sessions 2 and 3 was associated with greater symptom change among patients who had fewer years of education. More homework completion after Sessions 8 and 9 was associated with larger subsequent decreases in PTSD. Average homework completion was not associated with client characteristics. In the second half of treatment, homework engagement was associated with less dropout. The results suggest that efforts to increase engagement in homework may facilitate symptom change.     

The impact of bilingual environments on selective attention in infancy

Bilingualism has been observed to influence cognitive processing across the lifespan but whether bilingual environments have an effect on selective attention and attention strategies in infancy remains an unresolved question. In Study 1, infants exposed to monolingual or bilingual environments participated in an eye‐tracking cueing task in which they saw centrally presented stimuli followed by a target appearing on either the left or right side of the screen. Halfway through the trials, the central stimuli reliably predicted targets' locations. In Study 2, the first half of the trials consisted of centrally presented cues that predicted targets' locations; in the second half, the cue–target location relation switched. All infants performed similarly in Study 1, but in Study 2 infants raised in bilingual, but not monolingual, environments were able to successfully update their expectations by making more correct anticipatory eye movements to the target and expressing faster reactive eye latencies toward the target in the post‐switch condition. The experience of attending to a complex environment in which infants simultaneously process and contrast two languages may account for why infants raised in bilingual environments have greater attentional control than those raised in monolingual environments.