The effectiveness of counselling with older people: Results of a systematic review

In 2003 the British Association for Counselling and Psychotherapy (BACP) commissioned a systematic review of the research evidence relating to counselling older people. This paper reports on some of the findings of this review, particularly those which address the effectiveness of counselling with this population. Electronic searches of the research literature spanned six databases and were supplemented by hand‐searches of reference lists and key journals, along with an extensive search of the “grey” literature. The location of papers testing interventions which fall within a definition of counselling set out by the BACP, with samples aged 50 years of age or above resulted in the inclusion of 47 relevant studies. Studies investigated a variety of mental health problems in older people, particularly depression, anxiety, dementia and the psychological impact of physical conditions such as chronic obstructive pulmonary disease. Of the 47 studies, eight tested counselling as a generic treatment, 15 tested cognitive behavioural therapy, 13 tested reminiscence therapy, and 11 tested various other specific approaches. The review concluded that counselling is efficacious with older people, particularly in the treatment of anxiety and depression and outcomes are consistent with those found in younger populations. Evidence as to the efficacy of counselling interventions in the treatment of dementia is weak.     

Factor structure and differential validity of the expanded Brief Psychiatric Rating Scale

The Brief Psychiatric Rating Scale (BPRS) is one of the most widely used measures in psychiatric outcome and clinical psychopharmacology research. To date, however; research on the psychometric properties of the expanded version of the BPRS (BPRS-E) has been limited. An exploratory factor analysis (n = 360) using maximum likelihood extraction with oblimin rotation found a four-factor solution (Thought Disturbance, Animation, Mood Disturbance, Apathy) to underlie the BPRS-E. Furthermore, these factors were logical in nature and estimates of internal consistency were acceptable. A confirmatory factor analysis conducted on a second, independent sample (n = 280)found that for the five models currently available in the literature, the model developed herein provided the best fit to the data. Again, estimates of internal consistency were found acceptable. Finally, the four factors demonstrated appropriate differential validity with regards to both demographic variables and various psychiatric diagnoses.     

Differential susceptibility and the early development of aggression: interactive effects of respiratory sinus arrhythmia and environmental quality

The purpose of the current study was to predict the development of aggressive behavior from young children's respiratory sinus arrhythmia (RSA) and environmental quality. In a longitudinal sample of 213 children, baseline RSA, RSA suppression in response to a film of crying babies, and a composite measure of environmental quality (incorporating socioeconomic status and marital adjustment) were measured, and parent-reported aggression was assessed from 18 to 54 months of age. Predictions based on biological sensitivity-to-context/differential susceptibility and diathesis-stress models, as well as potential moderation by child sex, were examined. The interaction of baseline RSA with environmental quality predicted the development (slope) and 54-month intercept of mothers' reports of aggression. For girls only, the interaction between baseline RSA and environmental quality predicted the 18-month intercept of fathers' reports. In general, significant negative relations between RSA and aggression were found primarily at high levels of environmental quality. In addition, we found a significant Sex × RSA interaction predicting the slope and 54-month intercept of fathers' reports of aggression, such that RSA was negatively related to aggression for boys but not for girls. Contrary to predictions, no significant main effects or interactions were found for RSA suppression. The results provide mixed but not full support for differential susceptibility theory and provide little support for the diathesis-stress model.     

Pretense,Counterfactuals, and Bayesian Causal Models: Why What Is Not Real Really Matters

Young children spend a large portion of their time pretending about non‐real situations. Why? We answer this question by using the framework of Bayesian causal models to argue that pretending and counterfactual reasoning engage the same component cognitive abilities: disengaging with current reality, making inferences about an alternative representation of reality, and keeping this representation separate from reality. In turn, according to causal models accounts, counterfactual reasoning is a crucial tool that children need to plan for the future and learn about the world. Both planning with causal models and learning about them require the ability to create false premises and generate conclusions from these premises. We argue that pretending allows children to practice these important cognitive skills. We also consider the prevalence of unrealistic scenarios in children's play and explain how they can be useful in learning, despite appearances to the contrary.     

Intentions,foreseen consequences and the doctrine of double effect

The difficulty of distinguishing between the intended and the merely foreseen consequences of actions seems to many to be the most serious problem for the doctrine of double effect. It has led some to reject the doctrine altogether, and has left some of its defenders recasting it in entirely different terms. I argue that these responses are unnecessary. Using Bratman’s conception of intention, I distinguish the intended consequences of an action from the merely foreseen in a way that can be used to support the doctrine of double effect.     

A test of the interactive effects of anxiety sensitivity and mindfulness in the prediction of anxious arousal, agoraphobic cognitions, and body vigilance

The present investigation sought to examine the interactive effects of anxiety sensitivity [AS; Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss, & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107-121). San Diego: Academic Press] and mindfulness [Brown, K. W., & Ryan, R. M. (2003). The benefit of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822-848] in predicting panic-relevant processes. A community sample of 248 individuals participated in the study by completing a battery of self-report instruments. Consistent with prediction, the interaction between AS and mindfulness significantly predicted anxious arousal symptoms and agoraphobic cognitions, above and beyond the individual main effects, and did not significantly predict anhedonic depression symptoms. Contrary to prediction, the AS by mindfulness interaction did not significantly predict body vigilance. Theoretical implications are discussed and future directions are delineated.     

Associative retrieval processes in the human medial temporal lobe: hippocampal retrieval success and CA1 mismatch detection

Hippocampal subfields CA(3) and CA(1) are hypothesized to differentially support the generation of associative predictions and the detection of associative mismatches, respectively. Using high-resolution functional MRI, we examined hippocampal subfield activation during associative retrieval and during subsequent comparisons of memory to matching or mismatching decision probes. Activity in the dentate gyrus/CA(2/3), CA(1), and other medial temporal lobe subregions tracked associative retrieval success, whereas activity in CA(1) and the perirhinal cortex tracked the presence of associative mismatches. These data support the hypothesis that CA(1) acts as a "comparator," detecting when memory for the past and sensory input in the present diverge.     

Semantic versus phonological false recognition in aging and Alzheimer's disease

Patients with Alzheimer's disease (AD) have been found to exhibit lower levels of false recognition of semantic associates compared with healthy older adults. Because these patients may show impaired performance of episodic and semantic memory tasks, this finding could be explained by deficits in episodic memory, semantic memory, or both. The authors adapted a paradigm for comparison of semantic versus phonological false recognition. They found that: (a) patients with AD exhibited lower levels of corrected false recognition of semantic, phonological, and hybrid (mixed semantic and phonological) lists than older adults, and (b) patients with AD showed very similar levels of false recognition for all list types. These results suggest that only episodic memory deficits are necessary to explain the lower level of false recognition of semantic associates observed in patients with AD when compared to older adults. Additionally, (c) older adults showed greater levels of semantic, phonological, and hybrid false recognition than younger adults, extending previous false recognition research of semantically related words and categorized colored photographs to phonologically related words.     

Reasoning strategies: the role of working memory and verbal-spatial ability

Evidence increasingly suggests individual differences in strategies adopted on reasoning tasks and that these are either verbal-propositional or visuospatial in nature. However, the cognitive foundations of these strategies remain uncertain. Experiment 1 examined the relationship between the use of working memory resources and strategy selection for syllogistic reasoning. Verbal and spatial strategy users did not differ on working memory capacity, but confirmatory factor analysis indicated that while verbal reasoners draw primarily on verbal working memory, spatial reasoners use both this and spatial resources. Experiment 2 investigated the relationship between strategies and verbal and spatial abilities. Although strategy groups were similar in overall ability, regression analysis showed that performance on a spatial ability measure (Vandenberg mental rotation task) predicted syllogistic reasoning performance, but only for spatial strategy users. The findings provide converging evidence that verbal and spatial strategies are underpinned by related differences in fundamental cognitive factors, drawing differentially on the subcomponents of working memory and on spatial ability.     

Moral Testimony: Transmission Versus Propagation

The status of moral testimony has recently been challenged, for both epistemic and non-epistemic reasons. This paper distinguishes two methods of teaching: transmission, “classic” learning from testimony, that results in second hand knowledge, and propagation which results in first hand knowledge and understanding. Moral propagation avoids most of the epistemic and non-epistemic problems of transmission. Moreover, moral propagation can develop and refine non-cognitive attitudes too. Therefore moral testimony should (and normally does) take the form of moral propagation, not transmission.