Risking Everything in Obsessive–Compulsive Disorder: An Analogue Decision-Making Study

An experiment examined decision-making processes among nonclinical participants with low or high levels of OCD symptomatology (N?=?303). To better simulate the decision environments that are most likely to be problematic for clients with OCD, we employed decision tasks that incorporated “black swan” options that have a very low probability but involve substantial loss. When faced with a choice between a safer option that involved no risk of loss or a riskier alternative with a very low probability of substantial loss, most participants chose the safer option regardless of OCD symptom level. However, when faced with choices between options that had similar expected values to the previous choices, but where each option had some low risk of a substantial loss, there was a significant shift towards riskier decisions. These effects were stronger when the task involved a contamination based, health-relevant decision task as compared to one with financial outcomes. The results suggest that both low and high symptom OC participants approach decisions involving risk-free options and decisions involving risky alternatives in qualitatively different ways. There was some evidence that measures of impulsivity were better predictors of the shift to risky decision making than OCD symptomatology.

     

Genetic Counseling in the Era of Genomics: What’s all the Fuss about?

As genomic sequencing becomes more widely available in clinical settings for diagnostic purposes, a number of genetic counseling issues are gaining precedence. The ability to manage these issues will be paramount as genetic and non-genetic healthcare professionals navigate the complexities of using genomic technologies to facilitate diagnosis and inform patient management. Counseling issues arising when counseling for diagnostic genomic sequencing were identified by four genetic counselors with 10 years of collective experience providing genetic counseling in this setting. These issues were discussed and refined at a meeting of genetic counselors working in clinical genomics settings in Melbourne, Australia. Emerging counseling issues, or variations of established counseling issues, were identified from the issues raised. Illustrative cases were selected where pre- and post-test genetic counseling was provided in clinical settings to individuals who received singleton or trio WES with targeted analysis. Counseling issues discussed in this paper include a reappraisal of how genetic counselors manage hope in the genomic era, informed consent for secondary use of genomic data, clinical reanalysis of genomic data, unexpected or unsolicited secondary findings, and trio sequencing. The authors seek to contribute to the evolving understanding of genetic counseling for diagnostic genomic sequencing through considering the applicability of existing genetic counseling competencies to managing emerging counseling issues and discussing genetic counseling practice implications.     

Predictive Relationship Between Parental Beliefs and Accommodation of Pediatric Anxiety

Behavior performed by parents to assist a youth in avoiding or alleviating anxiety, known as accommodation, is ubiquitous among pediatric anxiety disorders and strongly related to poor treatment outcome. According to cognitive-behavioral theory, the beliefs parents hold regarding accommodation should predict parental accommodating behavior. Unfortunately, little is known about the beliefs parents hold regarding accommodation, as there exists no validated measure of this construct. First, the psychometric properties were examined for the Parental Accommodation Scale (PAS), a novel measure of parental accommodating behavior frequency (PAS-Behavior scale) and parental beliefs about accommodation (PAS-Belief scale). Second, the relationship between parental beliefs about accommodation and accommodation frequency was examined. Results provide preliminary evidence of the internal consistency and convergent validity of the PAS. Stronger positive beliefs about accommodation significantly predicted accommodation frequency, even after controlling for youth anxiety severity. Specifically, beliefs that accommodation prevents youth from losing behavioral and emotional control significantly predicted accommodation frequency. Therefore, efforts to decrease accommodation in clinical settings should involve correcting maladaptive parental beliefs about accommodation, with a particular emphasis on beliefs regarding the necessity of accommodation in preventing a youth from losing behavioral and emotional control.     

Latent Growth Curve and Repeated Measures ANOVA Contrasts: What the Models are Telling You

The relationship between the latent growth curve and repeated measures ANOVA models is often misunderstood. Although a number of investigators have looked into the similarities and differences among these models, a cursory reading of the literature can give the impression that they are very different models. Here we show that each model represents a set of contrasts on the occasion means. We demonstrate that the fixed effects parameters of the estimated basis vector latent growth curve model are merely a transformation of the repeated measures ANOVA fixed effects parameters. We further show that differences in fit in models that estimate the same means structure can be due to the different error covariance structures implied by the model. We show these relationships both algebraically and through using data from a simulation.     

An Affordance-Based Approach to Visually Guided Overtaking

When an automobile driver overtakes a lead vehicle while avoiding oncoming traffic, does he or she do so with reference to the limits of his or her car? We investigated overtaking from the perspective of the theory of affordances. We define the overtake-ability affordance as a ratio of the minimum satisfying velocity required for safe overtaking (MSV) to the maximum velocity of the driver's car (V_max). Two groups of participants performed overtaking maneuvers, if deemed possible, by driving either a slow (V_max = 25 m/s) or a fast (V_max = 32.5 m/s) virtual car in overtaking situations constrained by 14 values of MSV. For any given MSV condition, participants in the fast car group were more likely to attempt an overtaking maneuver. However, when MSV was expressed in intrinsic units as a ratio of V_max for both groups, the frequency of overtaking was not significantly different across groups. Furthermore, overtaking frequency dropped to near 0% for both groups when MSV exceeded V_max. In accordance with the affordance-based framework (Fajen, 2007), our results suggest that participants select their overtaking maneuvers by perceiving an overtake-ability affordance.     

The role of cognitive factors in the pathogenesis of obsessive-compulsive symptoms: a prospective study

Cognitive models of obsessive-compulsive disorder (OCD) posit that specific kinds of dysfunctional beliefs (e.g., pertaining to responsibility and the significance of intrusive thoughts) underlie the development of this disorder. The present study was designed to prospectively evaluate whether dysfunctional beliefs thought to underlie OCD act as a specific vulnerability factor in the pathogenesis of obsessive-compulsive symptomatology. Eighty-five individuals were prospectively followed over a period of time thought to be associated with an increased onset of OCD symptoms -- childbirth and the postpartum. The majority of these new mothers and fathers experienced intrusive infant-related thoughts and performed neutralizing behaviors similar to, but less severe than, those observed in OCD. Scores on a measure of dysfunctional beliefs thought to underlie OCD predicted the development of obsessive-compulsive symptoms after controlling for pre-existing OCD symptoms, anxiety, and depression. Dysfunctional beliefs also predicted the severity of checking, washing, and obsessional OCD symptom dimensions, but not neutralizing, ordering, or hoarding symptom dimensions. These data provide evidence for specific dysfunctional beliefs as risk factors in the development of some types of OCD symptoms.     

Retrieval-induced facilitation: initially nontested material can benefit from prior testing of related material

Classroom exams can assess students' knowledge of only a subset of the material taught in a course. What are the implications of this approach for long-term retention? Three experiments (N = 210) examined how taking an initial test affects later memory for prose materials not initially tested. Experiment 1 shows that testing enhanced recall 24 hr later for the initially nontested material. This facilitation was not seen for participants given additional study opportunities without initial testing. Experiment 2 extends this facilitative effect to a within-subjects design. Experiment 3 demonstrates that this facilitation can be modulated by conscious strategies. These results have implications for educational practice and the theoretical developments of the testing effect, associative memory, and retrieval inhibition.     

Learning to control collisions: the role of perceptual attunement and action boundaries

The authors investigated the role of perceptual attunement in an emergency braking task in which participants waited until the last possible moment to slam on the brakes. Effects of the size of the approached object and initial speed on the initiation of braking were used to identify the optical variables on which participants relied at various stages of practice. In Experiments 1A and 1B, size and speed effects that were present early in practice diminished but were not eliminated as participants learned to initiate braking at a rate of optical expansion that varied with optical angle. When size and speed were manipulated together in Experiment 2, the size effect was quickly eliminated, and participants learned to use a 3rd optical variable (global optic flow rate) to nearly eliminate the speed effect. The authors conclude that perceptual attunement depends on the range of practice conditions, the availability of information, and the criteria for success.     

Targeting the probability versus cost of feared outcomes in public speaking anxiety

Cognitive-behavioral theory suggests that social phobia is maintained, in part, by overestimates of the probability and cost of negative social events. Indeed, empirically supported cognitive-behavioral treatments directly target these cognitive biases through the use of in vivo exposure or behavioral experiments. While cognitive-behavioral theories and treatment protocols emphasize the importance of targeting probability and cost biases in the reduction of social anxiety, few studies have examined specific techniques for reducing probability and cost bias, and thus the relative efficacy of exposure to the probability versus cost of negative social events is unknown. In the present study, 37 undergraduates with high public speaking anxiety were randomly assigned to a single-session intervention designed to reduce either the perceived probability or the perceived cost of negative outcomes associated with public speaking. Compared to participants in the probability treatment condition, those in the cost treatment condition demonstrated significantly greater improvement on measures of public speaking anxiety and cost estimates for negative social events. The superior efficacy of the cost treatment condition was mediated by greater treatment-related changes in social cost estimates. The clinical implications of these findings are discussed.     

Trajectories of perceived support in mother-adolescent relationships: the poor (quality) get poorer

The authors examined decreases across the early adolescent years in child reports of perceived support from mothers to determine whether the rate of decline differed as a function of the initial amount of perceived negativity in the mother-child relationship. Participants included a diverse sample of 197 girls and 116 boys who were in the 1st year of middle school (6th grade, ages 11 to 13 years) at the beginning of the study. Separate growth curve models revealed associations between the rate of change in child-reported perceived support and the initial level of both child-reported perceived negativity and mother-reported perceived negativity. Over-time declines in child-reported perceived support were larger for adolescents whose initial levels of perceived negativity were greater. The findings are consistent with the claim that mothers and children with the worst relationships at the outset of adolescence experience the greatest deterioration in relations across the early adolescent years.