The BAI–PC as a Screen for Anxiety, Depression, and PTSD in Primary Care

Despite the prevalence of psychiatric disorders in medical settings, mental health problems often go undetected and patients do not receive appropriate treatment. The main goal of this study is to provide additional information about the Beck Anxiety Inventory – Primary Care (BAI–PC), a brief instrument that screens for patients with anxiety. This study provides information on the performance of the BAI–PC as a screening instrument for depression and PTSD in addition to its original purpose as a screening instrument for anxiety. This efficient tool can identify patients who can benefit from effective psychological treatments and facilitate referrals to psychologists working in medical settings.     

Telling a story or telling it straight: the effects of entertaining versus accurate retellings on memory

People retell events for different reasons. Sometimes they try to be accurate, other times entertaining. What characterizes retellings from different perspectives? How does retelling perspective affect later recall of events? In the current research, participants retold a story either three times or not at all. By instruction, retellings were either entertaining or accurate. Compared to accurate retellings, entertaining retellings contained more affect, but fewer sensory references. On a subsequent memory test, participants who retold with an accuracy goal recalled the greatest number of story events, and their recall protocols were the most accurate and detailed, and least exaggerated. However, recognition memory did not differ across groups, suggesting that differences in retrieval structures (necessary for recall but not recognition) were key to understanding later differences in memory. Compared to telling it straight, the creative process of telling a story leads to qualitative and quantitative changes in later recall. Copyright © 2004 John Wiley & Sons, Ltd.     

Coping with a threatened group identity: Psychosocial and neuroendocrine responses

Given the stress associated with belonging to a socially devalued group, members' reactions to a threat were evaluated within a stress and coping framework. Participants (N=72) were presented with an explicit or nonexplicit (positive vs. neutral cues) threat to a devalued identity. Regressions indicated that problem-focused coping was related to appraising the identity threat as controllable, and with a greater sense of optimism. Together these variables were associated with lower salivary cortisol levels. The role of emotion-focused coping was most evident under explicit threat conditions, such that it was associated with sustained cortisol elevations and a diminution of identity importance. The findings suggest that intergroup responses involve a complex interplay among stressor appraisals and coping propensities.     

Mothers' Reactions to Children Misbehaving in Ways That Can Lead to Injury: Implications for Gender Differences in Children's Risk Taking and Injuries

A scenario methodology in which mothers imagined themselves and their school-age children in different home situations was used to examine mothers' reactions to sons and daughters when the children were misbehaving in ways that could, and sometimes did, result in injuries. Prior to injury, mothers predominantly expressed anger to sons and disappointment to daughters, focusing primarily on safety issues in response to daughters' misbehavior and discipline issues in response to sons' misbehavior. Once an injury resulted, mothers became concerned about their children, but the degree of concern was greater for injuries to daughters than to sons. Sons' risky misbehavior was attributed predominantly to nonmodifiable characteristics, whereas daughters' risky misbehavior was attributed to factors that a parent could expect to influence. Consistent with these attributions, mothers advocated active injury-prevention approaches to prevent injury recurrence to daughters, but did not believe that much else could be done to prevent injury recurrence to sons. Generally, the pattern of results support the notion that mothers expect more risky behavior of sons than of daughters, are more concerned about injuries to daughters than sons, and believe they can have greater influence on the risk-taking behavior of daughters than sons. Implications of these results for understanding gender differences in children's risk-taking and injuries are discussed.     

Rates and Correlates of DSM-IV Diagnoses in Women Newly Diagnosed with Breast Cancer

Although the presence of psychological distress has been documented in women with breast cancer, previous studies have not established rates of DSM-IV diagnoses in this population, nor have prior investigations compared the utility of diagnostic interviewing vs. symptom checklists to assess distress. DSM-IV diagnoses of anxiety disorders and major depression, symptoms of anxiety and depression, and quality of life were examined in 207 women with newly diagnosed breast cancer. Eighteen percent of breast cancer patients met criteria for a current DSM-IV anxiety or depressive disorder and 54% met criteria for a disorder at some point in their lifetime. These rates are comparable to those found in recent community epidemiological studies (e.g., R. C. Kessler, K. A. McGonagle, S. Zhao, C. B. Nelson, M. Hughes, S. Esheman, et al., 1994). Sensitivity, specificity, and positive predictive value for anxiety and depression symptoms as predictors of DSM disorders were relatively poor. However, after accounting for demographic, treatment, and cancer variables, self-reported anxiety symptoms were significantly related to the presence of an anxiety disorder and self-reported depressive symptoms were significantly related to a diagnosis of a depressive disorder. Symptoms of anxiety and depression contributed significantly and uniquely to physical, medical, and sexual quality of life; DSM-IV diagnoses were not significantly related to quality of life after controlling for symptoms of depression and anxiety. The importance of measuring both symptoms of distress and psychiatric diagnoses in cancer patients and the clinical practice implications of the results are discussed.     

Comments on Jason Stanley's “On the Linguistic Basis for Contextualism”

Philosophical Studies -     

The therapeutic alliance: Adolescent perspectives

This paper presents a conceptualisation of the therapeutic alliance from the adolescent perspective and discusses implications for practitioners. The main aim of the study was to focus on the factors that participants identified as important in relationship formation and maintenance. Eighteen individuals were interviewed using a semi‐structured format. Three major themes were identified: therapeutic environment, uniqueness of the therapeutic relationship, and therapist characteristics. Participants identified both positive and negative aspects of the therapeutic relationship. A strong alliance was found to be necessary in that the perception of the therapist as accepting, supportive and trustworthy influenced the adolescent's evaluation of the appropriateness of therapeutic tasks and goals. Participants stressed the importance of the supportive nature of the relationship in their willingness to collaborate in therapeutic interventions.     

Personal epistemology and theory of mind: deciphering young children's beliefs about knowledge and knowing

The beliefs that individuals hold about knowledge and knowing have been the focus of a growing body of work on “personal epistemology.” There has been general agreement among researchers about a developmental trajectory of epistemological understanding that takes place in adolescence and adulthood. Rarely has this research included children, however, and we know little about the origins of epistemological awareness or its early development. A separate group of researchers have investigated children's “theory of mind,” or the ability to understand others’ beliefs, actions, and desires, with primary attention to the onset of this cognitive achievement between the ages of 3 and 5. This article reviews the theoretical foundation for a proposed relation between these constructs, and reports on an exploratory investigation with 3–5 year olds, in which epistemological level was significantly related to theory of mind ability. Results are discussed in relation to a general timeline depicting the development of children's beliefs about knowledge and knowing, a process that involves an ongoing tension between objective and subjective perspectives. We propose that the trajectory of epistemological development be expanded to include an initial period of egocentric subjectivity that characterizes epistemological thinking prior to the achievement of theory of mind.     

Reasons for Reason-giving in a Public-Opinion Survey

This paper explores why respondents to a telephone public-opinion survey often give reasons for answering as they do, even though reason-giving is neither required nor encouraged and it is difficult to see the reasons as attempts to deal with disagreement. We find that respondents give reasons for the policy claims they make in their answers three times as frequently as they give reasons for value or factual claims, that their reasons tend to involve appeals to personal experience, and that they often talk about their thought processes, especially when the evidentiary stakes are high. We then explore several ways of explaining these findings. We suggest that one useful approach is to see the reason-giving in the survey interviews as deliberative, reflexive argumentation of the sort described as `critical thinking. We further suggest that the reason such argumentation is often conducted out loud in the interviews, rather than internally, is that it functions in the service of rhetorical ethos, in particular the need to display the fact that one is human, with human autonomy and agency. Doing this may be particularly important in contexts such as anonymous survey interviews in which people are at risk of being treated like machines.     

A Type Hierarchy of Selection Processes for the Evaluation of Evolutionary Analogies

In this paper I propose a type-hierarchy approach to provide an intersubjective framework for the evaluation of evolutionary analogies. This approach develops David Hull’s and others’ attempts to provide full generalisation for selection processes, in order to show that sociocultural development and, particularly, scientific change can be considered as an instance of Darwinian selection. I argue that the recent work by Eileen Cornell Way on type hierarchies can offer the kind of generalisation needed to solve the main problems that still affect Hull’s theory and to show that the evolutionary analogy is, after all, only a particular way of grouping phenomena together. If Hull’s main objective is a unified theory of selection, which supports the idea that science selection and natural selection obey the same laws, I also argue that the type hierarchy approach to models shows that this objective is unsustainable as it stands, and is in need of further development. I will firstly introduce the general outline of the type hierarchy approach to models. Then, after a brief recapitulation of Hull’s main points and difficulties, I will try and construct a hierarchy for a general abstraction of selection processes. Finally I will introduce the main criticisms that Hull’s work has faced from philosophers and scientists, and show how they compare with my proposal.