Cognitive and Behavioral Treatments for Anxiety and Depression in a Patient with an Implantable Cardioverter Defibrillator (ICD): A Case Report and Clinical Discussion

Implantable cardioverter-defibrillators (ICDs) are the treatment of choice for patients at risk for potentially life threatening arrhythmias. The associated stress of living with an implanted device and receiving ICD shock therapy has been noted to exert a psychological toll on the individual patient and family. Anxious and depressive symptomatology is frequently reported by these patients, thus creating a demand for tailored psychological interventions for this population. The current case report describes the components, delivery, and effectiveness of a targeted treatment approach for anxiety and depression in an individual with an ICD. Test results and interview data revealed significant improvements in multiple domains of cognitive, emotional, and behavioral functioning. Improvements in marital relations were also achieved. These treatment effects were maintained at follow-up and in the context of acute, medical stressors. Future clinical and research directions are also discussed.     

Developmental Changes in Response to Frustration among Physically Handicapped Children

Methods of coping with frustration were examined in handicapped and nonhandicapped children at three different age levels, by means of the Rosenzweig P-F Study. While an extrapunitive approach was predominant in both groups and did not differ between the groups, significant differences were found in the use of secondary coping strategies. When compared with nonhandicapped counterparts, handicapped six year olds were more likely to minimize or deny frustration. At 10 years, handicapped Ss were more likely than nonhandicapped Ss to be intropunitive or self-blaming. There was a developmental tendency for handicapped Ss to make greater use of intropunitive responses with increasing age.     

Developing an instrument to measure physical activity related self-worth in women: Rasch analysis of the Women's Physical Activity Self-Worth Inventory (WPASWI)

ObjectivesThe objective of this study is to report on the development of an instrument to assess non-physical aspects of physical activity (PA)-related self-worth (SW).MethodsThree hundred thirty five women (mean age = 36.69 ± 15.94 yrs, BMI = 24.87 ± 4.56) completed the Women's Physical Activity Self-Worth Inventory (WPASWI), General SW Scale, and a PA Questionnaire. Rasch analysis was used to evaluate the WPASWI.ResultsThree PA-related SW subscales were identified: PA Knowledge (16 items), PA Emotional (13 items), and PA Social (8 items). Rasch analysis supported construct validity, and items demonstrated acceptable internal consistency (Cronbach's alpha = 0.90, 0.87 and 0.72) and test-re-test reliability (r = 0.79, 0.70, 0.81). Women who reported regular PA participation had higher PA Knowledge, PA Emotional, PA Social, and General SW than those who reported some or no PA (p < 0.01) and correlations between Knowledge, Emotional, and Social SW subscales and General SW were 0.207, 0.130, and 0.220, respectively. PA Knowledge and PA Emotional SW had stronger correlations with PA (r = 0.344, 0.273, respectively) than did General SW (r = 0.133).ConclusionsThe WPASWI demonstrated good internal consistency, reliability, construct validity and a stronger relationship with PA than a General SW instrument.     

Guilty,But Not Ashamed: “True” Self‐Conceptions Influence Affective Responses to Personal Shortcomings

The current research examined how true self‐conceptions (who a person believes he or she truly is) influence negative self‐relevant emotions in response to shortcomings. In Study 1 (N = 83), an Internet sample of adults completed a measure of authenticity, reflected on a shortcoming or positive life event, and completed state shame and guilt measures. In Study 2 (N = 49), undergraduates focused on true versus other determined self‐attributes, received negative performance feedback, and completed state shame and guilt measures. In Study 3 (N = 138), undergraduates focused on self‐determined versus other determined self‐aspects, reflected on a shortcoming or neutral event, and completed state shame, guilt, and self‐esteem measures. In Study 4 (N = 75), undergraduates thought about true self‐attributes, an achievement, or an ordinary event; received positive or negative performance feedback; and completed state shame and guilt measures. In Study 1, differences in true self‐expression positively predicted shame‐free guilt (but not guilt‐free shame) following reminders of a shortcoming. Studies 2–4 found that experimental activation of true self‐conceptions increased shame‐free guilt and generally decreased guilt‐free shame in response to negative evaluative experiences. The findings offer novel insights into true self‐conceptions by revealing their impact on negative self‐conscious emotions.     

An examination of two-process theories of false recognition

Contemporary theories of false memory suggest there are two processes that combine to produce false memory: one that increases false memory (error-inflating processes) and one that counteracts false memory (error-editing processes). Two experiments using the DRM paradigm (Deese, 1959; Roediger & McDermott, 1995) explored the influence of manipulating the number of associates studied, study item presentation frequency, backward associative strength, and study time on error-inflating and error-editing processes separately by examining speeded and unspeeded recognition decisions. The results of these studies indicate that (1) increasing the number of associates studied primarily influenced error-inflating processes; (2) increasing backward associative strength increased error-inflating processes and impaired error-editing processes; (3) increasing study item presentation frequency increased both error-inflating and error-editing processes; and (4) increasing study time had a weak effect on error-editing processes. Further, the results of these studies suggest that comprehensive theories of false memory phenomena must propose the existence of two different factors: one that increases false memory and is available early in memory retrieval, and one that usually, but not always, decreases false memory and is available later in retrieval.     

Translating the Human Right to Water and Sanitation into Public Policy Reform

The development of a human right to water and sanitation under international law has created an imperative to implement human rights in water and sanitation policy. Through forty-three interviews with informants in international institutions, national governments, and non-governmental organizations, this research examines interpretations of this new human right in global governance, national policy, and local practice. Exploring obstacles to the implementation of rights-based water and sanitation policy, the authors analyze the limitations of translating international human rights into local water and sanitation practice, concluding that system operators, utilities, and management boards remain largely unaffected by the changing public policy landscape for human rights realization. To understand the relevance of human rights standards to water and sanitation practitioners, this article frames a research agenda to ensure that human rights aspirations lead to public policy reforms and public health outcomes.     

Cognitive inhibition in selection and sequential retrieval

Inhibitory models of working memory efficiency (Engle, 1996; Zacks & Hasher, 1994) assert that individual differences in working memory reflect the efficiency of inhibitory processes that exclude irrelevant information and suppress no-longer-relevant information. The present study examined the implication that these two inhibitory processes operate at consistent levels of efficiency within individuals by examining the correlation between two cognitive inhibition effects, negative priming and negative error priming. Negative priming involves slower response to a probe-trial target that was used as a to-be-ignored distractor on the immediately preceding prime trial. Negative error priming is the phenomenon that errors in a sequence of simple arithmetic trials are unlikely to involve the correct answer to the preceding problem. Participants received distractor-target pairs of simple addition problems and were required to produce the target problem sum. Negative priming was observed for prime distractors, whereas negative error priming was observed in connection with previous targets but not distractors. Consistent with the assumptions of these working memory models, the magnitudes of the two effects were significantly correlated.     

Synaesthesia: the prevalence of atypical cross-modal experiences

Sensory and cognitive mechanisms allow stimuli to be perceived with properties relating to sight, sound, touch, etc, and ensure, for example, that visual properties are perceived as visual experiences, rather than sounds, tastes, smells, etc. Theories of normal development can be informed by cases where this modularity breaks down, in a condition known as synaesthesia. Conventional wisdom has held that this occurs extremely rarely (0.05% of births) and affects women more than men. Here we present the first test of synaesthesia prevalence with sampling that does not rely on self-referral, and which uses objective tests to establish genuineness. We show that (a) the prevalence of synaesthesia is 88 times higher than previously assumed, (b) the most common variant is coloured days, (c) the most studied variant (grapheme-colour synaesthesia)--previously believed most common--is prevalent at 1%, and (d) there is no strong asymmetry in the distribution of synaesthesia across the sexes. Hence, we suggest that female biases reported earlier likely arose from (or were exaggerated by) sex differences in self-disclosure.     

Perceiving patterns of play in dynamic sport tasks: investigating the essential information underlying skilled performance

The perceptual-cognitive information used to support pattern-recognition skill in soccer was examined. In experiment 1, skilled players were quicker and more accurate than less-skilled players at recognising familiar and unfamiliar soccer action sequences presented on film. In experiment 2, these action sequences were converted into point-light displays, with superficial display features removed and the positions of players and the relational information between them made more salient. Skilled players were more accurate than less-skilled players in recognising sequences presented in point-light form, implying that each pattern of play can be defined by the unique relations between players. In experiment 3, various offensive and defensive players were occluded for the duration of each trial in an attempt to identify the most important sources of information underpinning successful performance. A decrease in response accuracy was observed under occluded compared with non-occluded conditions and the expertise effect was no longer observed. The relational information between certain key players, team-mates and their defensive counterparts may provide the essential information for effective pattern-recognition skill in soccer. Structural feature analysis, temporal phase relations, and knowledge-based information are effectively integrated to facilitate pattern recognition in dynamic sport tasks.     

Exploring Genetic Counseling Communication Patterns: The Role of Teaching and Counseling Approaches

The educational and counseling models are often touted as the two primary professional approaches to genetic counseling practice. Yet, research has not been conducted to examine how these approaches are used in practice. In the present study, we conducted quantitative communication analyses of BRCA1 genetic counseling sessions. We measured communication variables that represent content (e.g., a biomedical focus) and process (e.g., passive listening) to explore whether genetic counselor approaches are consistent with prevailing professional models. The Roter Interaction Analysis System (RIAS) was used to code 167 pre-test genetic counseling sessions of members of a large kindred with an identified BRCA1 mutation. Three experienced genetic counselors conducted the sessions. Creating composite categories from the RIAS codes, we found the sessions to be largely educational in nature with the counselors and clients devoting the majority of their dialogue to providing biomedical information (62 and 40%, respectively). We used cluster analytic techniques, entering the composite communication variables and identified four patterns of session communication: Client-focused psychosocial, biomedical question and answer, counselor-driven psychosocial, and client-focused biomedical. Moreover, we found that the counselors had unique styles in which they combined the use of education and counseling approaches. We discuss the importance of understanding the variation in counselor communication to advance the field and expand prevailing assumptions.