Buffering Effects of Benefit Finding in a War Environment

Benefit finding (BF) has been extensively examined after exposure to traumatic events. However, less research has examined BF as a buffer against the negative effects of an ongoing stressful event. Data from 1,925 U.S. Army soldiers deployed in support of Operation Iraqi Freedom (OIF) was used to examine whether BF would moderate the relationship between combat exposure and posttraumatic stress disorder (PTSD) and depression. Regression analyses revealed that BF was associated with lower levels of PTSD and depression. However, we found that BF during the combat deployment was found to moderate the combat exposure–PTSD relationship, such that the relationship was stronger when BF was low. Results are discussed in terms of BF being a form of meaning-based coping that may help soldiers adjust to the challenges of war.     

Declining medical decision-making capacity in mild AD: a two-year longitudinal study

This is a report of a two-year longitudinal study comparing healthy older adult subjects (n = 15) and mild Alzheimer's disease (AD) patients (n = 20) using an objective performance measure of medical decision-making capacity (MDC). Capacity to consent to medical treatment was measured using the Capacity to Consent to Treatment Instrument (CCTI). The CCTI is a psychometric measure that tests MDC using a series of four core capacity standards: S1 (evidencing/communicating choice), S3 (appreciating consequences), S4 (providing rational reasons), and S5 (understanding treatment situation), and one experimental standard [S2] (making the reasonable treatment choice). For each standard, mild AD patients were assigned one of three capacity outcomes (capable, marginally capable, or incapable) based on cut-off scores derived from control group performance.At baseline, mild AD patients performed equivalently with controls on simple standards of evidencing a choice (S1) and making the reasonable choice ([S2]), but significantly below controls on complex standards of appreciation, reasoning, and understanding (S3, S4, and S5) (p < 0.02). Control performance was stable over time on all capacity standards. At one-year follow-up, the mild AD group did not show significant decline from baseline on any capacity standard. However, at two-year follow-up the mild AD group showed significant declines from baseline on the three complex standards (S3, S4, and S5) (p < 0.02), and a trend on one of the simple standards (S1). Over the two-year period, the proportion of marginally capable and incapable outcomes in the AD group increased substantially for four of the five standards (S1, S3, S4, and S5). Performance on [S2] remained stable over time in the AD group.We conclude that mild AD patients have impaired MDC at baseline, and demonstrate significant additional decline on complex consent abilities of appreciation, reasoning, and understanding over a two-year period. AD patients also show emerging impairment on the simple consent ability of evidencing choice at two-year follow-up. Capacity outcome data reflect similar declines over time for these four consent standards. The findings suggest the value of early assessment and regular monitoring at two-year intervals of MDC in patients with mild AD.     

Internet-based treatment for panic disorder

Increasingly, the internet is being used as a source of mental health information as well as structured treatment programs for people with mental health concerns or problems. The present review focuses mainly on research conducted at the University of Ballarat in Australia, and Uppsala University in Sweden, on internet-based treatment for panic disorder, one of the more common and disabling anxiety disorders. Our studies suggest that internet-based cognitive behavioural therapy is an effective intervention for panic disorder, and that it is more effective than some other self-help therapies. We have found that this mode of intervention is associated with clinically significant change, improved psychological well-being and functioning, and low participant attrition, provided that timely, limited therapist assistance is also provided. This review also discusses treatment credibility and participant satisfaction, as well as assessment and crisis management issues. Although promising as a form of intervention, there is a need for more research on the efficacy of internet-based treatment for PD and on comparisons with evidence-based face-to-face therapies.     

Testing the stress-buffering effects of self engagement among soldiers on a military operation

The present research examined whether self engagement moderated the stressor-strain relationship in a sample of U.S. soldiers deployed on a peacekeeping mission to Bosnia. Given that individuals were nested within groups (Army companies), we examined the relationships of interest using multilevel random coefficient models. The results of these analyses revealed that self engagement interacted with three different stressors (lower amounts of sleep, work stress, family stress) in the prediction of psychological distress. In support of self engagement as a buffer against stress, when stressors were low (high amounts of sleep, low levels of work stress, and family stress), soldiers reported relatively low levels of psychological distress and physical symptoms, regardless of whether they were engaged in or disengaged from their job. However, when stressor levels were high, soldiers who were engaged in their job reported less elevation in reports of psychological distress than soldiers who were disengaged from their job. The results are discussed in terms of the potential mechanisms by which self engagement might protect individuals from stressful circumstances.     

Therapist training in video chat technology for use in an adaptive digital mental health intervention: Challenges,facilitators and implications for training models

Objective

This qualitative study investigated therapist training experiences, elements of skill acquisition, and barriers and facilitators associated with conducting assessments, and the delivery of low- and high-intensity therapist assistance delivered via video chat technology, adjunctive to a transdiagnostic digital mental health intervention programme for anxiety and depression.

Methodology

In total, 34 semistructured interviews were conducted with 20 therapists. Twenty interviews explored experiences of training to administer a clinical assessment tool, and 14 additional interviews explored training experiences of delivering low- and high-intensity therapist assistance via video chat technology.

Results

Reflexive thematic analysis identified three themes: video chat skill acquisition, competencies transferrable to video chat and video chat service quality. Training and supervision were identified as important to scaffold skill development, and therapists described surprise that their skill set was transferrable to video chat. The most cited barrier to the adoption of video chat was the management of risk and distress, along with environmental suitability. Frequently cited facilitators to the adoption of video chat included stable Internet connection, protocols and resources.

Conclusion

The benefits of video chat technology and digital mental health interventions can be maximised through the expansion and integration of training into existing teaching curricula. If therapists are familiarised and competent to deliver mental health services via the Internet, as well as in person, the future adoption of blended and stepped-care models is likely to be increased.     

On threat of shock as an elicitor of anxiety: a methodological note.

The effects of anxiety on the eyeblink component of the human startle response were measured in 32 college students. The manipulation of threat of shock was not successful in eliciting anxiety, suggesting that, while threat of shock can increase anxiety, this increase is not inevitable, illustrating the importance of a manipulation check of the effectiveness of the threat.     

AIDS-Related Stigmatization: Instrumental and Symbolic Attitudes1

We investigate the role that instrumental and symbolic functions of attitudes play in the rejection of people infected with HIV. In a series of studies (total N = 431), we manipulate the symbolic component of AIDS, by comparing it to a fictitious disease that is identical in every way to AIDS, excepting its symbolic association with homosexuality and IV drug use. Two studies indicated that the symbolic component had no effect on either social distance or perceptions of disease severity. A third study indicated that instrumental aspects of severity, contagiousness, and treatability were significant determinants of social distance. A fourth study found that the stigma of association with homosexuality increased a mild disease's stigma. A fifth study showed that previous research showing the importance of a symbolic component in AIDS-related attitudes may have relied on a confounded measure of the symbolic component of attitudes. These 5 studies suggest the importance of both instrumental and symbolic attitudes in illness. Instrumental functions seem to outweigh the impact of symbolic functions of AIDS-related attitudes.     

Collecting responses through Web page drag and drop.

This article describes how to collect responses from experimental participants using drag and drop on a Web page. In particular, we describe how drag and drop can be used in a text search task in which participants read a text and then locate and categorize certain elements of the text (e.g., to identify the main claim of a persuasive paragraph). Using this technique, participants respond by clicking on a text segment and dragging it to a screen field or icon. We have successfully used this technique in both the argument element identification experiment that we describe here and a tutoring system that we created to teach students to identify source characteristics while reading historical texts (Britt, Perfetti, Van Dyke, & Gabrys, 2000). The implementation described here exploits the capability of recent versions of Microsoft's Internet Explorer Web browser to handle embedded XML documents and drag and drop events.     

Knowing where is different from knowing what: Distinct response time profiles and accuracy effects for target location,orientation, and color probability

When a location is cued, targets appearing at that location are detected more quickly. When a target feature is cued, targets bearing that feature are detected more quickly. These attentional cueing effects are only superficially similar. More detailed analyses find distinct temporal and accuracy profiles for the two different types of cues. This pattern parallels work with probability manipulations, where both feature and spatial probability are known to affect detection accuracy and reaction times. However, little has been done by way of comparing these effects. Are probability manipulations on space and features distinct? In a series of five experiments, we systematically varied spatial probability and feature probability along two dimensions (orientation or color). In addition, we decomposed response times into initiation and movement components. Targets appearing at the probable location were reported more quickly and more accurately regardless of whether the report was based on orientation or color. On the other hand, when either color probability or orientation probability was manipulated, response time and accuracy improvements were specific for that probable feature dimension. Decomposition of the response time benefits demonstrated that spatial probability only affected initiation times, whereas manipulations of feature probability affected both initiation and movement times. As detection was made more difficult, the two effects further diverged, with spatial probability disproportionally affecting initiation times and feature probability disproportionately affecting accuracy. In conclusion, all manipulations of probability, whether spatial or featural, affect detection. However, only feature probability affects perceptual precision, and precision effects are specific to the probable attribute.