Cognitive-Behavioral Therapy: Innovations for Cardiopulmonary Patients With Depression and Anxiety

Medically ill patients face unique physical and emotional challenges that place them at increased risk for symptoms of depression and anxiety. Despite high prevalence and significant impact, depression and anxiety are infrequently treated in the medically ill because of a variety of patient, provider, and system factors. The current article describes the development of an innovative, modular-based cognitive-behavioral intervention (Adjusting to Chronic Conditions Using Education Support and Skills [ACCESS]) that integrates treatment for symptoms of anxiety and depression with medical disease self-management in patients with heart failure and chronic obstructive pulmonary disease. Data from 3 patients who participated in an ongoing open clinical trial are reviewed to illustrate the feasibility, acceptability, and potential strengths and limitations of this intervention.     

Maternal Attributions Related to Compliance with Cystic Fibrosis Treatment

This study examined mothers' attributions related to their children's compliance with various components of medical treatment for cystic fibrosis (CF). Mothers of children with CF were queried regarding adherence rates and reasons for child compliance with chest physiotherapy, inhalation therapy, exercise, medication, and dietary treatments. Maternal attributions for compliance were assessed on the dimensions of parental locus, stability, and controllability. Mothers reported significantly less compliance with diet than with other CF treatments; they also perceived the reasons for compliance with diet and exercise as more external and less under their control. These findings are discussed in relation to parent–child interactions that may be critical to improving treatment adherence, particularly in the context of nutritional interventions.     

Misperceptions about Norm Misperceptions: Descriptive,Injunctive, and Affective ‘Social Norming’ Efforts to Change Health Behaviors

We have known for a long time that people are often motivated to conform to the wishes of groups. Such peer influence can shape human behavior through the creation of social norms, and the frequency of some health behaviors (e.g., alcohol use) may depend on the perception of these norms. We discuss the influence of perceived social norms, especially normative misperceptions on health behaviors. We then describe social norms campaigns that are intended to reduce risky health behaviors by ‘debiasing’ perceptions of behavioral norms, and we point out practical problems and faulty theoretical assumptions of such interventions. A better alternative might be to develop interventions that debias misperceptions of injunctive norms or affective norms, although such alternatives have not yet been adequately tested. Still, we present the theoretical grounding for these different approaches and preliminary data suggesting that they could be successful in reducing risky health behaviors.     

Timed excitatory conditioning under zero and negative contingencies

Rats (rattus norvegicus) anticipated the arrival of a food pellet unconditioned stimulus (US) even when the conditioned stimulus (CS) signaled no overall change or a substantial decrease in the overall rate of US occurrence. Pellet USs were scheduled probabilistically in the intertrial interval at either an equivalent rate (Experiment 1) or a four times higher rate (Experiments 2 and 3) than in the CS, which included one fixed-time target US. Conditioning has been said to involve learning "whether" (contingency) the CS signals a change in the US, and if so, "when" (contiguity) the US is scheduled to arrive. Our results suggest that "when" trumps "whether," challenging the received view that a positive CS-US contingency is necessary for successful conditioning.     

Compensatory properties of visual information in the control of isometric force

This experiment investigated the effects of spatial (gain) and temporal (frequency) properties of visual feedback on the control of isometric force output. Participants performed an index finger isometric force production task with five different levels of visual gain and four feedback frequencies. There was a significant effect of gain on mean and standard deviation (SD) of the force output, whereas feedback frequency significantly affected the force SD and root-mean square error. Significant effects of gain and frequency and a gain X frequency interaction on the approximate entropy (ApEn) of the force revealed the effect of visual feedback uncertainty on the force fluctuation dynamics. The combined effects of the spatial and temporal properties of visual feedback on ApEn were approximated by a sum of quadratic functions, indicating their compensatory effect on the informational content of the dynamics of isometric force.     

An exploration of lived religion in same-sex couples from Judeo-Christian traditions

Religious involvement has been found to be associated with higher levels of commitment and relationship satisfaction among heterosexually married individuals (Mahoney et al., 1999). Little is known, however, about the religiosity of gay, lesbian, bisexual (GLB) individuals, and virtually nothing is known about religious involvement in same-sex couples. The purpose of this qualitative interview study was to examine couples' experiences of incorporating religious involvement into their committed relationships. In a sample of 14 same-sex couples, we found that couples used their spiritual/religious values to understand and undergird their relationships. In this process, they negotiated intra-couple differences in religious practices, involved themselves in activities that have religious or spiritual meaning to them, created religious social support for their relationships, and experienced some non-supportive or rejecting interpersonal interactions with religious family members, congregants, and strangers. These findings are instructive to therapists who work with same-sex couples and the family members of GLB individuals. We conclude with specific suggestions for practitioners.     

Ethnic differences in the effects of spiritual well-being on long-term psychological and behavioral outcomes within a sample of homeless women

The present study examines ethnicity as a moderator variable between spiritual well-being (SWB) and psychological and behavioral outcomes. Participants included in this analysis were 88 African American (46.6%) and 101 non-African American (total N = 189) homeless mothers. Through structured interviews conducted at 3-month intervals over a period of 15 months, data were collected on spiritual well-being, mental health, trauma symptoms, substance use, parenting, and child behavior. Hierarchical linear model and general estimating equation results indicated that ethnicity moderates the relationship between SWB and anxiety, trauma symptoms, child behavior, and parenting outcomes. On average, African Americans reported significantly higher SWB than non-African Americans, indicating the relative importance of spirituality in their lives. These findings support previous research indicating a difference in the role that SWB plays in the lives of African Americans compared to non-African Americans.     

Care for Caregivers: Understanding the Need for Caregiver Support

Most long‐term care for older adults in the United States is provided by informal caregivers (Ahmad, 2012 ), the majority of whom experience an intense range of emotions from satisfaction to loneliness. Counselors must consider this emerging population of caretakers and learn methods to encourage clinical services to address their need for support. This article delineates experiences and challenges of informal caregivers and provides suggestions for effective clinical services for caregiver populations.     

Identification with Religion: Cross‐National Evidence from a Social Psychological Perspective

Why is religion a more central social identity for some people than for others? Previous studies focus on explaining individual differences in religious affiliation and religiosity, often using the term “identification” in reference to these concepts. Yet, few scholars operationalize—let alone attempt to explain—identification with religion in social psychological terms, i.e., as a construct that captures the subjective psychological centrality of one's religious identity. After underscoring the benefits of exploring religious identification using cross‐national data, we employ an original data set composed of nationally representative surveys in three European countries to model religious identification in two ways: importance (independent strength of attachment) and prominence (prioritization of one's religious identity relative to the others one holds). We document substantial variation in the degree to which individuals define themselves on the basis of their religious identity. We then test predictions drawn from existing theories to model these two measures. Our results extend current understandings of what shapes psychological attachment to religion and raise new questions for future theorization and analysis.