Special Considerations in the Adaptation of Cognitive Behavioral Therapy for Insomnia With Active-Duty U.S. Army Personnel

Insomnia is highly prevalent among active-duty military service members. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a well-established and effective treatment; however, research and treatment recommendations have primarily focused on civilian or veteran populations. A multitude of military-specific factors directly impact service members’ sleep and the subsequent treatment recommendations. This article provides treatment considerations for the use of CBT-I with active-duty U.S. Army personnel. First, an overview of the theoretical model of insomnia, including military-specific predisposing, precipitating, and perpetuating factors, is presented, followed by a review of common comorbid conditions among service members with insomnia. Finally, discussion focuses on considerations and strategies for implementing components of CBT-I with service members, managing sleep during deployments, and adjusting sleep to accommodate overnight duties. Additional training resources and supplemental video examples (with actors) are provided.     

Body Mass Index and functional impairment: the explanatory role of anxiety sensitivity among treatment-seeking smokers

Obesity and smoking are highly prevalent public health concerns in the United States. Data indicate that elevated Body Mass Index (BMI) is related to functional impairment. However, there is limited understanding of mechanisms that may explain their comorbidity among smokers. The current study sought to test whether anxiety sensitivity explained the relation between BMI and functional impairment among 420 (46.9% females; M_age = 38 years, SD = 13.42) treatment-seeking, adult smokers. Results indicated that BMI yielded a significant indirect effect through anxiety sensitivity for functional impairment, b = 0.01, SE = .01, 95% CI = [.002, .021]. These findings remained significant after controlling for participant sex, negative affectivity, tobacco dependence, psychopathology, and medical conditions (i.e. hypertension, heart problems, respiratory disease, asthma). Such data provide novel empirical evidence that, among smokers, BMI may be a risk factor for functional impairment indirectly through anxiety sensitivity. Overall, such findings could potentially inform the development of personalized interventions among this particularly vulnerable segment of the smoking population.     

Working models of attachment shape perceptions of social support: evidence from experimental and observational studies

Two studies examined the association between attachment style and perceptions of social support. Study 1 (N = 95 couples) used an experimental paradigm to manipulate social support in the context of a stressful task. Insecure participants (anxious and avoidant) who received low-support messages appraised these messages more negatively, rated a prior behavioral interaction with their partner as having been less supportive, and performed significantly worse at their task compared with secure participants. Study 2 (N = 153 couples) used a similar paradigm except that partners were allowed to send genuine support messages. Insecure participants (especially fearful) perceived their partners' messages as less supportive, even after controlling for independent ratings of the messages and relationship-specific expectations. These studies provide evidence that individuals are predisposed to appraise their support experiences in ways that are consistent with their chronic working models of attachment, especially when the support message is ambiguous.     

Prejudice expectations moderate preconscious attention to cues that are threatening to social identity

Two studies examined whether chronic and situational expectations about being stigmatized predict attention toward cues that are threatening to social identity. In Study 1, women's chronic expectations about experiencing sexism were positively associated with their attention toward subliminal cues threatening to their social identity. In Study 2, women were vigilant toward subliminal cues threatening to their social identity when the experimental situation conveyed that their gender was devalued, but not when the experimental situation promoted value and respect for their gender. Women were vigilant toward consciously presented cues threatening to their social identity regardless of the attitudes the experimental context conveyed toward their group. These studies have important theoretical and practical implications for understanding the psychological experience of possessing a devalued social identity.     

A secure base: responsive support of goal strivings and exploration in adult intimate relationships

A theoretical framework is proposed for examining the interpersonal processes involved in the support of a relationship partner's goal strivings, personal growth, and exploratory behavior, and for examining consequences of receiving either responsive or unresponsive support in this domain. These processes were examined using both observational and experimental methods. In Phase 1, couples were videotaped as they discussed personal goals for the future. In Phase 2, support behavior was experimentally manipulated to examine immediate effects on the recipient. Results indicated that responsive (nonintrusive) support of a relationship partner's goal strivings and explorations have important implications for the recipient's happiness, self-esteem, and perceived likelihood of achieving specific goals. The importance of research examining this type of support is discussed.     

Development of a school-wide behavior program in a public middle school: an illustration of deployment-focused intervention development, stage 1

School-wide behavior management systems can improve academic performance and behavior in middle schools, and they should have positive effects on students with ADHD. Unfortunately, evidence-based, school-wide behavior management systems have not been widely adopted because of problems with feasibility, acceptability, and sustainability. The Deployment-Focused Model of Intervention Development and Testing has been proposed as a promising method of bridging the gap between research and practice settings. A key aspect of the model is to involve the persons most likely to deliver the service (e.g., teachers) in the intervention development process from the very beginning. To illustrate this process, the authors describe the planning and implementation of a school-wide program designed to improve behavior in a public middle school.     

A prospective investigation of the relationship between just-world beliefs and the desire for revenge after September 11, 2001

We prospectively examined the relationship between individuals' belief in a just world and their desire for revenge against the perpetrators of the September 11 terrorist attacks against the United States. Eighty-three undergraduate students who had completed a measure of just-world beliefs prior to the terrorist attacks were assessed approximately 2 months following the attacks. The more strongly they had endorsed just-world beliefs prior to the attacks, the more distressed they felt about the attacks and the more they desired revenge. Furthermore, the relationship between belief in a just world and the desire for revenge was mediated by feelings of distress in response to the terrorist attacks. The results point to the importance of justice beliefs in understanding responses to the terrorist attacks.