Training needs among nonmental health professionals working with service members: A qualitative investigation

Though many service members will not directly seek mental health care due to stigma and other factors, they may interact with the healthcare system in other ways including contact with first responders, nurses, and allied health care professionals. However, little attention has been spent in this regard on the educational needs of these professionals whose contact with service members and Veterans may provide the opportunity to assist Veterans in need with overcoming barriers to accessing mental health care. This qualitative study investigates the educational training needs of first responders and health care professionals in contact with military families and trauma survivors to determine whether, and what type, of additional training is needed. A sample of 42 first responders and health care professionals including emergency medical technicians, police officers, fire fighters, speech language pathologists, occupational therapists, physical therapists, and nurses were recruited to participate in 1 of 6 focus groups. Sessions were audiotaped and transcribed verbatim. Data analysis was guided by a thematic analysis approach. Thematic analyses suggest there is a significant knowledge gap with unmet educational needs of these professionals such as information on the invisible wounds of war, military culture, and screening and referring patients who present symptoms falling outside professionals’ scope of practice. Findings point to a need and desire for more robust education for first responders and health care providers around mental health concerns of military populations, including topics such as trauma, military culture, and screening tools. Efforts to develop curricula addressing these concerns are warranted.     

Race,psychosocial vulnerability and social support differences in inner-city women's symptoms of posttraumatic stress disorder

Background/Objectives: Inner-city Black women may be more susceptible to posttraumatic stress disorder (PTSD) than White women, although mechanisms underlying this association are unclear. Living in urban neighborhoods distinguished by higher chronic stress may contribute to racial differences in women's cognitive, affective, and social vulnerabilities, leading to greater trauma-related distress including PTSD. Yet social support could buffer the negative effects of psychosocial vulnerabilities on women's health. Methods/Design: Mediation and moderated mediation models were tested with 371 inner-city women, including psychosocial vulnerability (i.e., catastrophizing, anger, social undermining) mediating the pathway between race and PTSD, and social support moderating psychosocial vulnerability and PTSD. Results: Despite comparable rates of trauma, Black women reported higher vulnerability and PTSD symptoms, and lower support compared to White Hispanic and non-Hispanic women. Psychosocial vulnerability mediated the pathway between race and PTSD, and social support moderated vulnerability, reducing negative effects on PTSD. When examining associations by race, the moderation effect remained significant for Black women only. Conclusions: Altogether these psychosocial vulnerabilities represent one potential mechanism explaining Black women's greater risk of PTSD, although cumulative psychosocial vulnerability may be buffered by social support. Despite higher support, inner-city White women's psychosocial vulnerability may actually outweigh support's benefits for reducing trauma-related distress.     

A review of cognitive biases in youth depression: attention,interpretation and memory

Depression is one of the most common mental health problems in childhood and adolescence. Although data consistently show it is associated with self-reported negative cognitive styles, less is known about the mechanisms underlying this relationship. Cognitive biases in attention, interpretation and memory represent plausible mechanisms and are known to characterise adult depression. We provide the first structured review of studies investigating the nature and causal role of cognitive biases in youth depression. Key questions are (i) do cognitive biases characterise youth depression? (ii) are cognitive biases a vulnerability factor for youth depression? and (iii) do cognitive biases play a causal role in youth depression? We find consistent evidence for positive associations between attention and interpretation biases and youth depression. Stronger biases in youth with an elevated risk of depression support cognitive-vulnerability models. Preliminary evidence from cognitive bias modification paradigms supports a causal role of attention and interpretation biases in youth depression but these paradigms require testing in clinical samples before they can be considered treatment tools. Studies of memory biases in youth samples have produced mixed findings and none have investigated the causal role of memory bias. We identify numerous areas for future research in this emerging field.     

Patterns of Response and Remission Following a One-Session Treatment for Blood-Injection-Injury Phobia in Youth

Blood-Injection-Injury (BII) Phobia is a severe and impairing disorder that has been understudied in youth. The present study aimed to define patterns of response and remission following a modified One-Session Treatment (OST) including an e-therapy maintenance program for children and adolescents with BII Phobia. Moreover, characteristics of different responder groups were examined in order to determine correlates of a poorer response. Youth (n?=?20; 8–18 years) were categorized into four responder groups (e.g., immediate remitter, delayed remitter, partial responder, and nonresponder) based upon defined criteria for remission. Immediate remitters to treatment were more likely to have a primary diagnosis of injection phobia, rather than a combined blood and injection phobia. Nonresponders reported significantly greater disgust sensitivity at pretreatment and were more likely to have a comorbid diagnosis of Social Phobia. In regards to within session change, youth who achieved the exposure goal of having a blood test during treatment had a significantly stronger treatment response. These preliminary findings may assist clinicians in the planning and delivering of intensive Cognitive Behavioral Treatment (CBT) approaches for BII Phobia in youth.     

Staff Practices and Social Skill Outcomes in a Sport-Based Youth Program

Staff are key contributors to quality sport-based youth programming. Specific practices leading to positive youth outcomes warrant further investigation. This study examined social skill outcomes resulting from participation in a sport-based youth program, LiFEsports. In addition, relationships among emotional and autonomy supportive staff practices and outcomes were examined. Results pointed to the value of sport-based youth programs for promoting self-control among youth from vulnerable backgrounds and indicated that youth-perceived emotional and autonomy supportive staff practices predicted improvements in perceived self-control but not perceived externalizing behaviors.     

A Brief Social Skills Intervention to Reduce Challenging Classroom Behavior

Social skills instruction has been recommended as a way of improving behavioral and social outcomes for students with emotional and behavioral disorders (EBD). A brief social skills intervention (Stop and Think (Knoff in The stop & think social skills program, Sopris West, Longmont, CO, 2001) was used to extend the current literature base for students with EBD. A multiple-baseline across classrooms design was used to examine negative social behavior of five participants attending a self-contained school setting for students with challenging behavior. The primary intervention components included: (a) teach, (b) model, (c) role play, and (d) performance feedback. Specific social skills addressed in intervention were listening, using nice talk, accepting consequences, ignoring others, and following directions. Participants were taught to use a 5-step process for each social skill: (1) stop and think, (2) identify good and bad choices, (3) identify steps to performing the good choice, (4) implement steps, and (5) reflect on the good choice you made. Results indicated students benefitted from 12 sessions of explicit social skills instruction as evidenced by decreases in negative social behavior. Social behavior improvements maintained during 2-week follow-up observations. Decreasing negative social behaviors is important in improving general social and behavioral outcomes as well as demonstrating growth toward being prepared to transition back to less restrictive environments. Limitations, recommendations for future research, and practice implications are discussed.     

Insightful problem solving and emulation in brown capuchin monkeys

We investigated problem solving abilities of capuchin monkeys via the “floating object problem,” a task in which the subject must use creative problem solving to retrieve a favored food item from the bottom of a clear tube. Some great apes have solved this problem by adding water to raise the object to a level at which it can be easily grabbed. We presented seven capuchins with the task over eight trials (four “dry” and four “wet”). None of the subjects solved the task, indicating that no capuchin demonstrated insightful problem solving under these experimental conditions. We then investigated whether capuchins would emulate a solution to the task. Seven subjects observed a human model solve the problem by pouring water from a cup into the tube, which brought the object to the top of the tube, allowing the subject to retrieve it. Subjects were then allowed to interact freely with an unfilled tube containing the object in the presence of water and objects that could be used to solve the task. While most subjects were unable to solve the task after viewing a demonstrator solve it, one subject did so, but in a unique way. Our results are consistent with some previous results in great ape species and indicate that capuchins do not spontaneously solve the floating object problem via insight.     

Cognitive Performance in Adults’ Daily Lives: Is There a Lab-Life Gap?

This article addresses the “lab-life gap” in cognitive aging research as an important issue of ecological validity in developmental research. Older adults often function competently in complex everyday situations despite age-related deficits on laboratory-based cognitive tasks. Therefore, to what extent do lab-based cognitive tasks predict real-life outcomes in older adults? Our review shows that although they are similar, measures of everyday cognitive competence predict relevant outcomes beyond basic measures. We provide our perspective on critical questions concerning the relevance of everyday cognitive tests in our ever-changing world, new methods of everyday cognitive assessment, and whether everyday cognition can be improved.