Anxiety Sensitivity and Interoceptive Exposure: A Transdiagnostic Construct and Change Strategy

Recent findings support the relevance of anxiety sensitivity (AS) and interoceptive exposure (IE) across emotional disorders. This study (a) evaluated levels of AS across different anxiety disorders, (b) examined change in AS over the course of transdiagnostic psychological intervention, and its relationship with outcome, and (c) described the implementation of IE to address AS with patients with different anxiety disorders. Participants (N = 54) were patients who received treatment with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) in two consecutive treatment trials. Participants completed a measure of AS at pre- and posttreatment, and multiple occasions during treatment. Symptom severity was assessed at pre- and posttreatment, and clinical information related to physical symptoms and IE were collected as part of routine clinical practice. Elevated AS was observed at pretreatment across diagnoses and decreases in AS were observed from pre- to posttreatment. Similar changes occurred across the diagnostic categories, notably coinciding with the introduction of IE. Change in AS was correlated with reduced symptom levels at posttreatment and 6-month follow-up. Patients with different anxiety disorders endorsed similar physical symptoms and practiced similar IE exercises with similar effects. Results provide preliminary support for the usefulness of IE as a treatment strategy across the spectrum of anxiety disorders, and additional support for the transdiagnostic relevance of AS.     

A Multi-Case Report of the Pathways To and Through Genetic Testing and Cancer Risk Management for BRCA Mutation-Positive Women Aged 18–25

Much of the extant literature addressing the psychosocial aspects of BRCA1/2 mutation testing and risk management aggregates mutation carriers of all ages in study recruitment, data analysis, and interpretation. This analytic strategy does not adequately address the needs of the youngest genetic testing consumers, i.e., women aged 18–25. Despite low absolute cancer risk estimates before age 30, BRCA1/2 mutation-positive women aged 18–25 feel vulnerable to a cancer diagnosis but find themselves in a management quandary because the clinical utility of screening and prevention options are not yet well defined for such young carriers. We present three cases, selected from a larger study of 32 BRCA1/2 mutation-positive women who completed or considered genetic testing before age 25, to demonstrate the unique developmental, relational and temporal influences, as well as the challenges, experienced by very young BRCA mutation-positive women as they complete genetic testing and initiate cancer risk management. The first case describes the maturation of a young woman whose family participated in a national cancer registry. The second addresses the experiences and expectations of a young woman who completed genetic testing after learning that her unaffected father was a mutation carrier. The third case highlights the experiences of a young woman parentally bereaved in childhood, who presented for genetic counseling and testing due to intense family pressure. Together, these cases suggest that BRCA1/2-positive women aged 18–25 are challenged to reconcile their burgeoning independence from their families with risk-related support needs. Loved ones acting in ways meant to care for these young women may inadvertently apply pressure, convoluting family support dynamics and autonomous decision-making. Ongoing support from competent healthcare professionals will enable these young women to remain informed and receive objective counsel about their risk-management decisions.     

Yoga Practice May Buffer the Deleterious Effects of Abuse on Women's Self-Concept and Dysfunctional Coping

Women who experienced abuse as children or adults can suffer from symptoms such as dissociations, physiological regulation difficulties, and mood disturbances that might not respond to traditional interventions. Given the benefits of yoga, we hypothesized that yoga practice would ameliorate the negative impact of abuse on psychological functioning. Our findings suggest that frequent yoga practice might ameliorate the negative impact of abuse history on self-concept and coping skills. In addition, our findings suggest that women who incorporate yoga into other areas of life could get the greatest psychological benefits. Given the preliminary nature of this study, further research into the benefits of yoga on women who have child or adult abuse histories is warranted.     

Becoming (Hetero) Sexual? The Hetero-Spectacle of Idollators and their Real Dolls

Guys and Dolls, a BBC documentary premiering in 2007 sketches out the lives of four men in relationships with silicone-fleshed, anatomically correct Real Dolls (RDs). The men in the documentary treat their RDs as if they are alive—they dress their dolls, rub their feet, and discuss what sex and the relationship with their dolls is like. In relating with their RDs, the men respond to concerns of having “no female company” at all. In this essay, combining Stein’s (Sexualities and society: a reader, Polity Press, Oxford, pp 132–142, 2003) notion of “be-coming out,” with Deleuze and Guattari’s (A thousand plateaus: capitalism and schizophrenia, University of Minnesota Press, Minneapolis, 1987) theory of becoming, we contend that the documentary actively represents the men’s pasts in order to make sense of, justify, and construct the dynamics of their current sexual selves. Because the idollator’s be-coming narratives illuminate their heteronormative shortcomings, these sexual origin stories take a confessional tone. Although confessions regarding sexuality are not soul cleansing acts but are approval seeking performances that reify normative social boundaries, we argue for a queer reading of the Guys and Dolls text which subverts the dominant logic of heteronormativity.     

The role of attentional set on attentional cueing and inhibition of return

When people know what critical feature will define a target for a block of trials, only cues that share a critical feature with targets will capture attention. This result is taken to mean that attentional control settings play a role in target identification. To examine the validity of the attentional control settings hypothesis while controlling for potential sensory artifacts, the first experiment compared conditions in which the critical target features were either blocked or randomized. The results indicated that all cues captured attention in the random conditions, but only cues that matched targets captured attention in the attentional set condition. The second experiment used the same two conditions to examine the effect of attentional set on inhibition of return (IOR). No differences were found between the blocked and random conditions, indicating that attentional set did not impact the IOR effects. Overall, the results indicate that (1) the previous findings of attentional set effects were not due to an artifact of the method, and (2) attentional set influences and early occurring attentional cueing effects but not later-occurring IOR effects.     

Daily Functioning, Health Status, and Happiness in Older Adults

The hypothesis that the degree to which disease disrupts daily functioning is inversely associated with happiness is widely accepted, yet existing literature offers little direct evidence in its support. This paper explores the hypothesized association in a community-based sample of 383 older adults. To assess the degree to which disease disrupts daily functioning we developed a measure—called the freedom-from-debility score—based on four Short Form-12 (SF-12) Health Survey questions explicitly designed to represent “limitations in physical activities because of health problems” and “limitations in usual role activities because of physical health problems.” The results were consistent with the hypothesis. When participants were divided into categories based on their freedom-from-debility score, median happiness scores were monotonically increasing across categories. Controlling for demographic and socio-economic factors as well as health status (measured both subjectively and objectively), a one-point increase in freedom-from-debility score (on a scale from 0 to 100) was associated with a three-percent reduction in the odds of lower-quartile happiness. The results support the contention that health status is one of the most influential predictors of happiness, that the association between health status and happiness depends greatly on the manner in which health status is measured, and that the degree to which disease disrupts daily functioning is inversely associated with happiness.     

Right-Wing Authoritarianism, Party Identification, and Attitudes Toward Feminism in Student Evaluations of the Clinton-Lewinsky Story

This study explored the relationship among undergraduates' right-wing authoritarianism (as measured by the RWA scale), attitudes toward feminism, party identification, gender, and attitudes about the Clinton-Lewinsky relationship. Factor analysis yielded three subscales, reflecting participants' evaluations of Clinton's morality, the affair, and Kenneth Starr (the independent counsel). Republican identification was related to each subscale and also mediated the relationship between RWA and two subscales, which illustrates how party identification channels the expression of personality variables in partisan contexts. In addition, RWA—especially those items tapping aggression—was directly related to negative evaluations of Clinton, which suggests a punitiveness going beyond the mere channeling of opinions by party identification. Attitudes toward feminism were unrelated to the subscales, possibly because feminism supporters viewed Clinton's policies positively but his behavior negatively. However, females did give significantly lower evaluations of Clinton and the affair.     

A job-seeking self-efficacy scale for people with physical disabilities: preliminary development and psychometric testing

People with disabilities are at an increased risk of unemployment. The role of interventions aiming to enhance the employment prospects of people with disabilities is receiving increased attention. However, evaluation is hampered by the paucity of measures specific to the needs of the target population. The purpose of the present study was to develop and conduct preliminary testing of the psychometric properties of a job-seeking self-efficacy (JSS) scale that reflected the experiences of people with physical disabilities. Job-seeking self-efficacy was defined as perceived ability to perform the skills involved in seeking employment that are salient to people with disabilities. Scale development and testing involved four studies and resulted in the 12-item JSS scale and six-item managing disability at interview (MDI) component, both of which were unidimensional and had high internal consistency. In addition, there was evidence of construct and concurrent validity. Greater jobseeking self-efficacy and perceived ability to manage disability at interview were associated with more positive psychological well-being. Only the MDI component was associated with physical functioning: lower perceived ability to manage disability at interview was associated with greater impairment of physical functioning. The pattern of associations supported the rationale for a separate component reflecting the need to resolve practical issues linked to access and availability of facilities before participation in the interview procedure per se .     

Treatment approaches for sleep difficulties in college students

College students face many challenges and live experiences that may lead to sleep difficulties, including: varied and changing schedules, repeated deadlines, increased freedom and self-responsibility, and group living arrangements, to name but a few. A high frequency of sleep difficulties is commonly reported among college student and others who encounter similar life experiences. The prevalence of sleep difficulties is explored and a rationale provided for treatment. It is suggested that interventionists need to consider the impact of sleep difficulties on their clients' immediate and long-term functioning. To help psychologists, counsellors, and therapists better ameliorate sleep problems a number of proven techniques are reviewed which are applicable to individuals in both clinical and non-clinical settings.