Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Imitation improves language comprehension

Humans imitate each other during social interaction. This imitative behavior streamlines social interaction and aids in learning to replicate actions. However, the effect of imitation on action comprehension is unclear. This study investigated whether vocal imitation of an unfamiliar accent improved spoken-language comprehension. Following a pretraining accent comprehension test, participants were assigned to one of six groups. The baseline group received no training, but participants in the other five groups listened to accented sentences, listened to and repeated accented sentences in their own accent, listened to and transcribed accented sentences, listened to and imitated accented sentences, or listened to and imitated accented sentences without being able to hear their own vocalizations. Posttraining measures showed that accent comprehension was most improved for participants who imitated the speaker's accent. These results show that imitation may aid in streamlining interaction by improving spoken-language comprehension under adverse listening conditions.     

Culture and beliefs about time: comparisons among black Americans, black Africans, and white Americans

The authors investigated the extent to which racial factors, cultural factors, or both influence a person's beliefs about physical time, personal time, and experienced and remembered duration. A total of 750 Black American, Black African, and White American students responded to a questionnaire on these beliefs about time. Factor analysis was used to compare belief structures. Pairwise comparisons, performed separately for each statement, tested the direction and strength of the reported beliefs. The groups showed many similarities, but they also showed some differences. All 3 groups differed in beliefs about physical and personal time, but they did not differ in beliefs about duration experiences. This evidence does not support simplistic views of racial or cultural influences. Culture may differentially influence beliefs about physical time and personal time. Beliefs about duration experiences may represent an ethnic factor that transcends cultures.     

Quality of life of adolescent males with attention-deficit hyperactivity disorder

Most psychosocial research on attention-deficit/hyperactivity disorder (ADHD) has focused on deficits in school, family, or behavioral functioning without incorporating perceived quality of life (QoL) or the adolescents' perspective. The Youth Quality of Life Instrument--Research Version (YQOL-R), was used to assess self-perceived QoL in a community sample of adolescents aged 11-18 years. Fifty-five adolescent males with a clinical diagnosis of ADHD were compared to a group of 107 adolescents with no chronic conditions (NCC) and a group of 52 adolescents with mobility impairments (MI). The adolescents with ADHD reported significantly lower perceived QoL scores, particularly in the Self and Relationship domains, than the NCC group. Their scores were similar to those from the group with MI, a group previously shown to have a substandard QoL. Interventions to improve self-esteem and social interactions might use QoL outcomes in evaluating effectiveness.     

The tripartite model of anxiety and depression: symptom structure in depressive and hypertensive patient groups

The structure of self-reported symptoms representative of the tripartite model was examined using data drawn from the Medical Outcomes Study (Tarlov et al., 1989). Participants were persons who had been diagnosed 48 months previously as suffering from either depression (N = 315) or hypertension (N = 403). Results of confirmatory factor analyses were broadly consistent with the tripartite model (L. A. Clark & Watson, 1991). Factors emerged corresponding to each of the 3 posited first-order dimensions of negative affect, positive affect, and physiologic arousal. Nonetheless, some discrepancies were found between the observed data and the hypothesized tripartite model. First, the obtained physiologic arousal factor was best viewed as reflecting nonspecific somatic distress rather than physiologic arousal. Finally, although differentiable in the strictest statistical sense, all three domains were significantly correlated (.36 to.86, absolute value). In particular, contrary to the tripartite model, positive and negative affect covaried markedly (-.81 to -.86). Findings raise issues concerning the utility of the tripartite model as a heuristic framework for enhancing understanding of individual differences in normal mood as well as mood disorders.     

The effects of goal progress cues: An implicit theory perspective

Consumers often encounter goods and services that provide cues to mark their progress. We define the term “goal progress cues” to reflect the diverse category of cues that highlight progress towards a goal. Across a series of three studies, we show that entity theorists, who rely on cues that highlight completion in order to signal their abilities to others, evaluate tasks that include these cues more favorably than those that lack these features. In contrast, incremental theorists, who focus on improving competence, are impacted only by progress cues that highlight learning. We demonstrate these findings across a variety of goal pursuit contexts that represent a mix of customer-centric (retail queues), service-oriented managerial (sales calls), and personal achievement consumer product (mazes) domains using both behavioral and self-reported measures. We conclude with a discussion about the theoretical and substantive implications of our findings.     

Like Mike: Ability contagion through touched objects increases confidence and improves performance

Magical thinking refers to irrational peculiar beliefs, including those that conform to the laws of contagion. We propose that touching an object that was previously touched by a high performer increases confidence via magical thinking (ability contagion) and improves actual performance among individuals high in experiential processing. A series of studies provides support for this main proposition. Our results cast doubt on an alternative explanation based on priming, and are obtained controlling for participants’ level of rational processing, motivation, and affect.     

Neurocognitive Function and Suicide in U.S. Army Soldiers

This prospective cohort study used administrative data from the Army Study to Assess Risk and Resilience in Servicemembers to examine associations between neurocognitive functioning and subsequent suicidal events among Regular Army enlisted soldiers during the years 2004–2009. Cases were all soldiers who completed the Army's Automated Neuropsychological Assessment Metrics (ANAM) computerized testing battery prior to documented suicide attempt (n = 607), ideation (n = 955), or death (n = 57). Controls were an equal‐probability sample of 9,893 person‐months from other soldiers. Exploratory factor analysis of five ANAM tests identified a general neurocognitive factor that excluded the mathematic processing test (MTH). When examined separately in logistic regression analyses that controlled for sociodemographics and prior mental health diagnosis, both the general neurocognitive factor (logit [β] = ?.197 to ?.521; p < .01) and MTH (β = ?.024 to ?.064; p < .05) were associated with all outcomes. When both predictors were examined simultaneously, the general neurocognitive factor continued to be associated with all outcomes (β = ?.164 to ?.417; p < .05) and MTH continued to be associated with suicide attempt (β = ?.015; p = .046) and ideation (β = ?.014; p = .018). These small but robust associations suggest that future research must continue to examine the extent to which objective neurocognitive tests may enhance understanding and prediction of suicide risk.