Issues in cognitive-behavioral interventions in academic skill areas 1

In this paper, conceptual and methodological issues within three phases of CBM interventions in academic skills are analyzed: Acquisition, evaluation, and generalization. The goal of such analysis is threefold: To enhance understanding of observed problems, clarify specific conceptual issues, and highlight areas that need more conceptual clarification and more research.     

Shame,Early Abuse,and Course of Depression in a Clinical Sample: A Preliminary Study

This study of 35 depressed patients was designed to replicate findings from a community sample of a relationship between childhood abuse and bodily shame, and bodily shame and chronic or recurrent depression. In addition, we investigated whether characterological and behavioural shame would also be related to early abuse and depression course. The relation between bodily shame and childhood abuse was replicated. When the other types of shame were considered, bodily shame was the most powerful correlate of early abuse, with behavioural shame showing no relationship. However, all three types of shame appeared to be related to chronic or recurrent course of depression.     

Not all skilled readers have cracked the code: individual differences in masked form priming

This experiment investigated whether individual differences in written language proficiency among university students predict the early stages of lexical retrieval tapped by the masked form priming lexical decision task. To separate the contributions of sublexical facilitation and lexical competition to masked form priming, the effects of prime lexicality were directly compared for both transposed-letter (TL) primes (e.g., sung SNUG; salb SLAB) and neighbor primes (e.g., snag SNUG; sleb SLAB) in a sample of 100 university students assessed on measures of reading, spelling and vocabulary. The data for the whole sample showed facilitation from nonword primes, but inhibition from word primes. Linear mixed models including the individual difference measures showed that higher scores on a principal component that captured the shared variance among reading, spelling, and vocabulary were associated with both stronger inhibition from TL word primes and stronger facilitation from neighbor nonword primes. These findings are consistent with the lexical quality hypothesis of reading that predicts that skilled readers vary in the extent to which they have developed precisely specified orthographic representations.     

From the Editors

Journal of Medical Humanities -     

Career Decision‐Making Intervention With Unemployed Adults: When Good Intentions Are Not Effective

This study adapted existing empirically supported interventions to explore options for serving large numbers of unemployed adults. Participants included 150 unemployed adults (72 experimental group, 78 control group) seeking employment office services to maintain U.S. federal unemployment compensation. A 1‐hour workshop was offered to the 72 experimental group participants. The same career development variables were assessed during data collection for both groups. Results revealed the workshop had no impact on negative career thinking and potentially increased career decision‐making difficulties in the experimental group. Intervention effectiveness issues, implications for future research, and intervention options with unemployed adults are discussed.     

Predictors of Genetic Testing Decisions: A Systematic Review and Critique of the Literature

Genetic testing is increasingly available in medical settings and direct-to-consumer. However, the large and growing literature on genetic testing decisions is rife with conflicting findings, inconsistent methodology, and uneven attention across test types and across predictors of genetic testing decisions. Existing reviews of the literature draw broad conclusions but sacrifice nuanced analysis that with a closer look reveals far more inconsistency than homogeny across studies. The goals of this paper are to provide a systematic review of the empirical work on predictors of genetic testing decisions, highlight areas of consistency and inconsistency, and suggest productive directions for future research. We included all studies that provided quantitative analysis of subjective (e.g., perceived risk, perceived benefits of testing) and/or objective (e.g., family history, sociodemographic variables) predictors of genetic testing interest, intentions, or uptake, which produced a sample of 115 studies. From this review, we conclude that self-reported and test-related (as opposed to disorder-related or objective) predictors are relatively consistent across studies but that theoretically-driven efforts to examine testing interest across test types are sorely needed.     

Relational processing following stroke

The research examined relational processing following stroke. Stroke patients (14 with frontal, 30 with non-frontal lesions) and 41 matched controls completed four relational processing tasks: sentence comprehension, Latin square matrix completion, modified Dimensional Change Card Sorting, and n-back. Each task included items at two or three levels of relational complexity. Relational processing was impaired in the stroke groups. This was due mainly to items at the intermediate ternary-relational level of complexity. Less complex binary-relational items and more complex quaternary-relational items (the latter are difficult for adults generally) were less sensitive to stroke status. Impairment was greater in frontal than non-frontal stroke patients. Positive inter-correlations among measures supported the domain-general nature of relational processing. Implications for assessment and intervention are discussed.     

The relative importance of patients’ decisional control preferences and experiences

Objective: Patients’ role in treatment decision-making can influence psychosocial and health-related outcomes (i.e. satisfaction, felt respect, adherence). We examined decisional control in a surgical context, identifying correlates of patients’ preferences and experiences.

Design: 380 patients and 7 surgeons were surveyed during initial surgical consultation visits in a low-income outpatient clinic.

Measures: Patients reported preferences for (pre-consultation) and experiences of (post-consultation) decisional control, demographics, satisfaction with care, and adherence to treatment recommendations. Surgeons rated patients’ health status.

Results: Preferences for and experiences of decisional control were unrelated, suggesting significant preference–experience misalignment. However, this misalignment did not appear to be consequential for patient outcomes. Rather, more decisional control, regardless of patients’ preferences, predicted greater satisfaction with care and greater self-reported adherence as assessed at a post-surgical appointment.

Conclusions: Decisional control predicts better outcomes for patients, regardless of their preferences for control over treatment decisions. These findings suggest that interventions should aim to increase patients’ degree of decisional control when feasible and appropriate.