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.     

Diurnal cycle of salivary cortisol in older adult men and women with subjective complaints of memory deficits and/or depressive symptoms: relation to cognitive functioning

In populations of young and older adults, it has been shown that individuals may be categorized into one of three diurnal subgroups when salivary cortisol levels are assessed over a 2-day period and compared for their consistency across days: a typical subgroup, a flat subgroup, and an inconsistent subgroup. Interestingly, recent studies have reported that the typical subgroup represents the majority of the young and older adult population, a finding that is difficult to reconcile with previous studies showing increased cortisol levels in older adults with depression or cognitive impairments. In order to assess whether a typical diurnal cortisol profile is representative across different subgroups of older adults, we assessed diurnal cortisol cycle representation in a sample of older adults with subjective complaints of depression and/or memory problems. Furthermore, given the robust relationship between cortisol and cognitive function, the present study examined the association between the three diurnal subgroups and cognitive performance. Forty-two older individuals were recruited on the basis of reporting subjective complaints of either memory problems and/or depressive mood. Participants were asked to sample their saliva over a 2-day period and were then asked to undergo a neuropsychological evaluation that taps into short-term memory, declarative memory and language. The results showed that 69% of the sample presented a Flat cycle of salivary cortisol over a 2-day period while 19% presented an inconsistent pattern and 12% presented a typical pattern. Participants in the flat subgroup were significantly impaired on letter verbal fluency. Furthermore, a relationship was found between diurnal cortisol subgroup representation and subjective complaint profile. These findings show that older adults with complaints of memory problems and/or depressive symptoms do not present the typical profile of the diurnal cortisol cycle, and they provide a preliminary view of how diurnal cortisol profile relates to cognitive function during human aging.     

Developmental changes in personal goal orientation from young to late adulthood: from striving for gains to maintenance and prevention of losses

Using a multimethod approach, the authors conducted 4 studies to test life span hypotheses about goal orientations across adulthood. Confirming expectations, in Studies 1 and 2 younger adults reported a primary growth orientation in their goals, whereas older adults reported a stronger orientation toward maintenance and loss prevention. Orientation toward prevention of loss correlated negatively with well-being in younger adults. In older adults, orientation toward maintenance was positively associated with well-being. Studies 3 and 4 extend findings of a self-reported shift in goal orientation to the level of behavioral choice involving cognitive and physical fitness goals. Studies 3 and 4 also examine the role of expected resource demands. The shift in goal orientation is discussed as an adaptive mechanism to manage changing opportunities and constraints across adulthood.     

Soluble interleukin 2 receptor levels, temperament and character in formerly depressed suicide attempters compared with normal controls

An imbalance of the immune system and mixed personality profiles in suicide attempters have been reported. As suicidal behavior is common in patients with psychiatric disorders within the spectrum of depressive features, in this study we measured soluble interleukin-2 receptor concentrations in plasma (sIL-2R) and investigated temperament and character profile and their potential correlation in formerly depressed patients with a history of suicide attempt. We studied sIL-2R levels in plasma and personality characteristics (using Cloninger's Temperament and Character Inventory [TCI]) of formerly depressed patients who had attempted suicide a mean of 3 years previously (n = 25), and age and gender matched normal controls (n = 25). There was no significant difference in sIL-2R levels between formerly depressed suicide attempters and age and gender matched normal controls (0.23 ng/ml +/- 0.25 vs. 0.19 ng/ml +/- 0.16). When compared to normal controls, suicide attempt patients had a significantly higher score on the temperament dimension "harm avoidance" and a lower score on the character dimension "self-directedness." No significant correlation was found between sIL-2R values and TCI dimensions. We propose that the liability to suicidal behavior among suicide attempters susceptible to depressive symptomatology may be related to high harm avoidance and low self-directedness.     

Task preparation and stimulus-evoked competition

The authors investigated how task competition evoked by a stimulus that affords both a currently relevant and a temporarily irrelevant task is affected by invalid preparation, i.e., preparation for the irrelevant task. Although invalid preparation was associated with a general performance cost, effects of stimulus-cued task competition were not enhanced on invalidly prepared trials. This result suggests that either preparation activates representations different from the ones by which stimulus cuing is mediated or that stimulus processing is postponed until invalid preparation has been corrected. In addition, invalid preparation resulted in impaired performance of the respective task when it became relevant on a subsequent trial. This result is consistent with the idea that competition due to invalid preparation is countered by task-specific inhibition.