A Selective Impairment in the Processing of Sad and Fearful Expressions in Children with Psychopathic Tendencies

The processing of emotional expressions is fundamental for normal socialisation and interaction. Reduced responsiveness to the expressions of sadness and fear has been implicated in the development of psychopathy (R. J. R. Blair, 1995). The current study investigates the sensitivity of children with psychopathic tendencies to facial expressions. Children with psychopathic tendencies and a comparison group, as defined by the Psychopathy Screening Device (PSD; P. J. Frick & R. D. Hare, in press), were presented with a cinematic display of a standardised set of facial expressions that depicted sadness, happiness, anger, disgust, fear, and surprise. Participants observed as these facial expressions slowly evolved through 20 successive frames of increasing intensity. The children with psychopathic tendencies presented with selective impairments; they needed significantly more stages before they could successfully recognise the sad expressions and even when the fearful expressions were at full intensity were significantly more likely to mistake them for another expression. These results are interpreted with reference to an amygdala and empathy impairment explanation of psychopathy.     

HIV/STD Risk Factors for Women with Violent Male Partners

This study compared 167 women, categorized as nonabused, emotionally abused, or physically abused in their primary relationships, on sexual risk factors. Physically abused women differed in several ways: greater STD risk, psychosocial distress, and substance use; more traditional gender role beliefs; lower self-esteem; more likely to have been raped and to engage in sex for pay; and less likely to attend the project's STD/HIV risk reduction groups. Within primary relationships, they differed in amount of decision-making power about safer sex, likelihood of nonmonogamy, use of substances before sex, and self-efficacy about initiating condom use. African American women reported higher rates of emotional abuse than White women, a finding related mainly to their lower socioeconomic status in this sample.     

Methodological and practical issues regarding phenomenological subtypes of highly suggestible individuals: A response to Kumar

A hypnotic induction produces different patterns of spontaneous experiences across individuals. The magnitude and characteristics of these responses covary moderately with hypnotic suggestibility, but also differ within levels of hypnotic suggestibility. This study sought to identify discrete phenomenological profiles in response to a hypnotic induction and assess whether experiential variability among highly suggestible individuals matches the phenomenological profiles predicted by dissociative typological models of high hypnotic suggestibility. Phenomenological state scores indexed in reference to a resting epoch during hypnosis were submitted to a latent profile analysis. The profiles in the derived four-class solution differed in multiple experiential dimensions and hypnotic suggestibility. Highly suggestible individuals were distributed across two classes that exhibited response patterns suggesting an inward attention subtype and a dissociative subtype. These results provide support for dissociative typological models of high hypnotic suggestibility and indicate that highly suggestible individuals do not display a uniform response to a hypnotic induction.     

Development of a Patient Adherence Scale for Exposure and Response Prevention Therapy

Exposure and response prevention (EX/RP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). For EX/RP to be maximally effective, it is believed that patients must adhere outside of sessions to the procedures they learn in therapy. To date, there is no standard measure of patient EX/RP adherence, despite the importance of accurately assessing EX/RP adherence in both clinical research and practice. This paper describes the development of the Patient EX/RP Adherence Scale (PEAS), which assesses the patient's between-session adherence to the therapist's EX/RP instructions, and presents initial data on the scale's reliability and validity. The scale was designed to focus on the key procedures of EX/RP and to be brief enough to be used at each treatment session. The scale demonstrates excellent interrater reliability and good face and content validity. The usefulness of the scale is considered in the context of being an important tool to researchers trying to understand and improve outcomes of EX/RP for OCD as well as to EX/RP therapists in clinical practice. Future research will need to test the scale's reliability and validity in a larger sample of patients over the course of treatment.     

Interpretation bias and depressive symptoms: The role of self-relevance

Cognitive theories of depression emphasize negatively biased interpretations as an important target of therapy. Much of the research on interpretation bias in depression has focused on selection, or deciding which of several interpretations is likely. However, depressive biases may also exist in the generation of possible interpretations, or the ability to think of positive alternatives. If biases exist for generation as well as selection, therapeutic techniques to encourage the generation of more positive interpretations would be warranted. Asking therapy clients to consider someone else in a similar situation is a commonly used therapy strategy but has not been sufficiently examined empirically. In the current studies, we examine interpretation generation and selection in dysphoric and nondysphoric individuals, and contrast interpretations made for the self to interpretations made for two types of “other.” Our studies reveal depressive biases in both interpretation generation and selection, and indicate that interpretation valence is highly sensitive to the type of other considered. All participants generated and selected significantly more positive interpretations for friends than for themselves, but generated significantly more negative interpretations for hypothetical others than for themselves. Our results suggest that encouraging dysphoric individuals to imagine others can be beneficial, but the type of “other” used is critically important, with instructions to consider a close friend most likely to be effective in decreasing negativity in interpretation.     

Integrating Exposure and Response Prevention With a Mobile App to Treat Obsessive-Compulsive Disorder: Feasibility,Acceptability, and Preliminary Effects

Many individuals with obsessive-compulsive disorder (OCD) do not receive evidence-based care (specifically exposure and ritual prevention; EX/RP) due to barriers such as a lack of EX/RP-trained clinicians, geographic obstacles, and the cost and time associated with the treatment. Offering an integrated treatment model consisting of brief in-person therapy coupled with a mobile application (app) might be one way to increase access to and reduce the time burden (to clinicians and patients) of EX/RP. This pilot trial evaluated the feasibility, acceptability, and clinical effects of such a treatment program for adults with OCD. Thirty-three participants enrolled in the 8-week open trial. The integrated treatment program consisted of 3 to 5 in-person sessions followed by weekly phone calls supported by a mobile app (nOCD). Participants were evaluated by trained raters and completed self-report measures at baseline, midtreatment, posttreatment and 2-month follow-up; the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) was the primary outcome. This integrated treatment program was feasible and acceptable to participants. Of the 33 study entrants, 14 (42%) responded to treatment (Y-BOCS decrease ≥ 35% with CGI- of 1 or 2), and 8 (24%) achieved minimal symptoms (i.e., Y-BOCS ≤ 12). At 2-month follow-up (n = 20), 7/20 (35%) met criteria for treatment response, and 3/20 (15.0%) met criteria for treatment remission. Although preliminary, this model warrants further study as an efficacious and resource-efficient way to deliver EX/RP for some patients with OCD.     

Learning to “See” Less Than Nothing: Putting Perceptual Skills to Work for Learning Numerical Structure

How can children's natural perceptuo-motor skills be harnessed for teaching and learning mathematical structure? We address this question in the case of the integers. Existing research suggests that adult mental representations of integers recruit perceptuo-motor functionalities involving symmetry. Building on these findings, we designed a hands-on curriculum that emphasizes symmetry to teach integer concepts to fourth graders. Compared to two control conditions, children who went through the experimental curriculum showed evidence of incorporating symmetry into their mental representations of integers and performed higher on problems beyond the scope of instruction, including negative fractions and algebra-readiness problems. Gains did not come at the expense of basic integer computation skill. This study has direct practical implications, as current integers curricula generally omit symmetry. The research demonstrates an approach to designing instruction that involves identifying perceptuo-motor functionalities underlying numerical cognition and creating learning activities to recruit them.     

Interpersonal Functioning in Obsessive–Compulsive Personality Disorder

The core symptoms of obsessive–compulsive personality disorder (OCPD) often lead to interpersonal difficulties. However, little research has explored interpersonal functioning in OCPD. This study examined interpersonal problems, interpersonal sensitivities, empathy, and systemizing, the drive to analyze and derive underlying rules for systems, in a sample of 25 OCPD individuals, 25 individuals with comorbid OCPD and obsessive–compulsive disorder (OCD), and 25 healthy controls. We found that OCPD individuals reported hostile-dominant interpersonal problems and sensitivities with warm-dominant behavior by others, whereas OCPD+OCD individuals reported submissive interpersonal problems and sensitivities with warm-submissive behavior by others. Individuals with OCPD, with and without OCD, reported less empathic perspective taking relative to healthy controls. Finally, we found that OCPD males reported a higher drive to analyze and derive rules for systems than OCPD females. Overall, results suggest that there are interpersonal deficits associated with OCPD and the clinical implications of these deficits are discussed.