Addressing Weight Suppression to Improve Treatment Outcome for Bulimia Nervosa

Cognitive behavioral therapy (CBT) is regarded as the gold-standard treatment for bulimia nervosa (BN), yet despite impressive empirical support for its effectiveness, over 50% of patients fail to achieve abstinence from binge eating and purging by the end of treatment. One factor that may contribute to reduced efficacy rates in CBT is weight suppression (WS; the difference between a person's highest weight ever at their adult height and current weight). A growing body of research indicates that WS in patients with BN may have a clinically significant effect on symptomatology and prognosis. However, the current cognitive behavioral framework for BN does not explicitly acknowledge the role of WS in the onset or maintenance of BN symptoms and does not provide guidance for clinicians on how to address WS during treatment. The relationship between WS, biological pressure to regain lost weight, and the maintenance of BN symptoms suggest that current cognitive behavioral models of BN may be improved by considering the role of WS and exploring needed treatment modifications. Indeed, a reconceptualization of existing models may offer insight into potential strategies that can be used to reduce the susceptibility to treatment dropout, nonresponse, and relapse. It is therefore necessary to consider whether, and how, clinicians' consideration of WS during case conceptualization and treatment planning could serve to improve CBT outcomes. The current review explores ways in which high WS could contribute to poor CBT outcomes, provides preliminary clinical recommendations for incorporating WS into existing cognitive behavioral treatments based on extant data and clinical wisdom, and proposes suggestions for future research needed in this domain.     

‘Interfaith dialogue’ as a form of opposition of ‘minority religions’ to governmental pressure in Russia

Russian governmental policy toward non-traditional religious groups, especially so-called New Religious Movements (NRMs), is discriminatory. Despite Russia’s formal secularity, the government strongly supports the Russian Orthodox Church (ROC), a position which results in various limitations on many other religious groups. As a result, legal actions have been initiated against new religious groups, for example the Bhagavad Gita trial in Tomsk, Siberia, and the designation of the literature of the Jehovah’s Witnesses as ‘extremist’. However, pressure by the government can sometimes lead to the development of spontaneous interreligious oppositional associations. One important example is the ‘interfaith dialogue’ in Tomsk, where local leaders or representatives of religious groups, such as the Episcopal, Jewish, and Latter-day Saints (Mormon) churches as well as the Hare Krishna movement, unorthodox Buddhist groups, and local pagan movements, united to oppose governmental and ROC efforts to disband a Hare Krishna group in the Tomsk area. This research note presents results of a case study, which involved participant observation, of the phenomenon of oppositional interfaith dialogue in Tomsk in the period 2011–2014. I discuss factors that influenced its appearance, its relationship with the local government, and the methods of cooperation between the different religious groups within this association and offer some theoretical interpretations of these developments. The results of this case study illustrate new and important modern relationships between minority religions and the government in Russia.     

A case-controlled field study evaluating ICD-11 proposals for relational problems and intimate partner violence

Background/Objective: Intimate partner relationship problems and intimate partner abuse and neglect — referred to in this paper as “relational problems and maltreatment” — have substantial and well-documented impact on both physical and mental health. However, classification guidelines, such as those found in the International Classification of Diseases (ICD-10), are vague and unlikely to support consistent application. Revised guidelines proposed for ICD-11 are much more operationalized. We used standardized clinical vignette conditions with an international panel of clinicians to test if ICD-11 changes resulted in improved classification accuracy. Method: English-speaking mental health professionals (N = 738) from 65 nations applied ICD-10 or ICD-11 (proposed) guidelines with experimentally manipulated case presentations of presence or absence of (a) individual mental health diagnoses and (b) relational problems or maltreatment. Results: ICD-11, compared with ICD-10, guidelines resulted in significantly better classification accuracy, although only in the presence of co-morbid mental health problems. Clinician factors (e. g., gender, language, world region) largely did not impact classification performance. Conclusions: Despite being considerably more explicated, raters’ performance with ICD-11 guidelines reveals training issues that should be addressed prior to the release of ICD-11 in 2018 (e. g., overriding the guidelines with pre-existing archetypes for relationship problems and physical and psychological abuse).     

Chronic stress, cognitive functioning and mental health

This review aims to discuss the evidence supporting the link between chronic stress, cognitive function and mental health. Over the years, the associations between these concepts have been investigated in different populations. This review summarizes the findings that have emerged from older populations as well as from populations suffering from pathological aging, namely Mild Cognitive Impairment and Alzheimer's Disease. Although older adults are an interesting population to study in terms of chronic stress, other stress-related diseases can occur throughout the lifespan. The second section covers some of these stress-related diseases that have recently received a great deal of attention, namely burnout, depression, and post-traumatic stress disorder. Given that chronic stress contributes to the development of certain pathologies by accelerating and/or exacerbating pre-existing vulnerabilities that vary from one individual to the other, the final section summarizes data obtained on potential variables contributing to the association between chronic stress and cognition.     

Left-handedness and male-male competition: Insights from fighting and hormonal data

Male-male competition can shape some behavioral or morphological traits of males. Here we investigate if this competition could play a role in the persistence of the polymorphism of handedness in human populations. A negative frequency-dependent selection mechanism has been hypothesized, based on the fact that left-handed men may benefit from a "surprise" advantage during fighting interactions because they are rare in human populations. This advantage may thereby enhance the probability of survival of left- handed men and/or their reproductive success through an increase in social status. In this study, we first explored the association between hand preference and lifetime fighting behavior in a population of 1,161 French men. No effect of hand preference on the probability of fighting was detected, suggesting that the innate propensity to fight does not differ between left- and right-handers. However, among men who had been involved in at least one fight during their lifetime, left-handers reported significantly more fights than right-handers. To explore the biological basis of this behavior, we also investigated the testosterone concentration in saliva samples from 64 French university students. Consistent with frequencies of fights, we found a significantly higher average testosterone concentration in left-handers than in right-handers. We suggest that these behavioral and hormonal differences may be acquired throughout life due to previous experiences in a social context and may favor the persistence of left-handers in humans.     

The influence of sentential position on noun phrase structure priming

This article explores the interaction between global sentence context and local syntactic decision making. Specifically, four noun phrase (NP) structural priming experiments investigated whether the position of an NP within a sentence increased speakers' tendency to repeat primed structure. We crossed the position of the NP with the structure of the NP, such that NPs could be sentence initial or final in prime sentences. We further manipulated whether the to-be-modified target NP was sentence initial or final. Structural persistence effects were consistently observed, but there was no influence of parallel position. Rather, sentence-initial NP primes had a stronger influence on subsequent syntactic decisions than sentence-final primes, suggesting a primacy effect. Sentence-initial target NPs contributed to this primacy effect, while sentence-final target NPs did not. We argue that this primacy effect arises as the result of greater processing demands and resources for early than for late sentence constituents as well as deeper encoding and more focused attention when processing the beginnings of sentences.     

Addressing social determinants of health: Supporting ex-offenders’ employment through use of the Systems Theory Framework

There remains a need for counselors well-prepared to work with ex-offenders. As counselors aim to meet ethical obligations toward advocacy, they often seek to address social determinants of health (SDOH) challenges. Those working with ex-offenders should be aware of unique employment challenges ex-offenders may face and possess a baseline knowledge of the justice system for pertinent collaboration. This paper provides an explanation of how the Systems Theory Framework may be used to address ex-offenders’ employment-related needs through addressing SDOH challenges and collaborating with the justice system. Implications for employment counselors, counselor educators, and supervisors and steps for future research conclude.     

Interaction effects among multiple job demands: an examination of healthcare workers across different contexts

Background and Objectives: Simultaneous exposure to time, cognitive, and emotional demands is a feature of the work environment for healthcare workers, yet effects of these common stressors in combination are not well established. Design: Survey data were collected from 125 hospital employees (Sample 1, Study 1), 93 ambulance service employees (Sample 2, Study 1), and 380 aged care/disability workers (Study 2). Methods: Hierarchical multiple regressions were conducted. Results: In Sample 1, high cognitive demand exacerbated high emotional demand on psychological strain and job burnout, whereas the negative effect of high emotional demand was not present at low cognitive demand. In Sample 2, a similar pattern between emotional demand and time demand on stress-remedial intentions was observed. In Study 2, emotional demand?×?time demand and time demand?×?cognitive demand interactions again revealed that high levels of two demands were stress-exacerbating and low levels of one demand neutralized the other. A three-way interaction on job satisfaction showed the negative impact of emotional demand was exacerbated when both time and cognitive demands were high, creating a “triple disadvantage” of job demands. Conclusions: The results demonstrate that reducing some job demands helps attenuate the stressful effects of other job demands on different employee outcomes.     

The use of selection,optimization, and compensation (SOC) in goal pursuit in the daily lives of middle-aged adults

The current study investigated the use of selection, optimization, and compensation (SOC) in association with momentary goal conflict and facilitation in middle adulthood. In contrast to previous studies on SOC that focused on the habitual use of the SOC-strategies, the current study investigated the momentary SOC-use in the everyday lives of adults who face the developmental challenge of combining the demands of multiple life domains (e.g., work, family, leisure). In a sample of N = 89 employed middle-age adults, momentary SOC-use as well as momentary goal conflict and facilitation were assessed in a measurement burst design encompassing 20 days (M = 126 measurement points per person). Time-lagged analyses showed that momentary goal conflict was positively related to subsequent optimization and compensation, and momentary goal facilitation lead to lower subsequent loss-based selection and compensation. In contrast, SOC predicted neither subsequent goal conflict nor facilitation. Thus, the use of SOC-strategies seems to be a response to – rather than an antecedent of - currently experienced goal relations (conflict, facilitation), underscoring the importance of these strategies for managing multiple goals.     

Length effect in reading and lexical decision: evidence from skilled readers and a developmental dyslexic participant

A number of experimental data have shown that naming latency increases with length for pseudo-words but not for frequent real words. Different interpretations have been proposed by current models of reading to account for such a length effect. The aim of the present study was to assess the impact of lexicality on length effect in both the reading and lexical decision tasks. For this purpose, skilled readers were asked to either name or make a lexical decision on words and pseudo-words differing in length from one to three syllables. Skilled readers' results show that length effect is modulated by lexicality in the reading task but no length effect was found in the lexical decision task. The tasks were further proposed to a well-compensated dyslexic participant who exhibited a visual attentional disorder in the absence of any associated phonological problems. A length effect on RTs was found for both words and pseudo-words in lexical decision but naming latencies were affected by length for the pseudo-words only. The present results largely conform to the predictions of the ACV98 model of reading. They are not compatible with the PDP models of reading and can only be partially accounted for by dual route models.