An integrated approach to delivering exposure-based treatment for symptoms of PTSD and depression in OIF/OEF veterans: preliminary findings

Combat-exposed military personnel from the wars in Iraq and Afghanistan report high rates of PTSD and associated psychiatric problems. A formidable body of research supports exposure therapy as a front-line intervention for PTSD; however, relative to studies of civilians, fewer investigations have evaluated the effectiveness of exposure therapy using military samples. Specifically, barriers to care (e.g., stigma associated with receiving mental health services ) may compromise utilization of evidence-based psychotherapy. As such, researchers have argued that veterans with PTSD may require an integrated and innovative approach to the delivery of exposure techniques. This paper presents the rationale for and preliminary data from an ongoing clinical trial that compares the home-based telehealth (HBT) application of a brief, behavioral treatment (Behavioral Activation and Therapeutic Exposure; BA-TE) for veterans with PTSD to the standard, in-person application of the same treatment. Forty OIF/OEF veterans with PTSD and MDD were consented, enrolled, and randomized to condition (BA-TE in-person, or BA-TE HBT) and symptoms of anxiety and depression were assessed at pre- and posttreatment. Participants in both conditions experienced reductions in depression, anxiety, and PTSD symptoms between pre- and posttreatment, suggesting that HBT application of an integrated PTSD treatment may be feasible and effective.     

Stress in Clinical Psychology Trainees: Current Research Status and Future Directions

The purpose of this article is to present the current status of the literature related to stress in clinical psychology trainees (CPTs), and to offer research directions for investigating stress in this population and ways to enhance self‐care in these individuals. The following conclusions emerge from the review: (1) CPTs are vulnerable to elevated stress; (2) undue stress can negatively impact CPTs' personal and professional functioning and, in turn, result in less than optimal standards of care for clients; (3) there is a dearth of studies on stress in this population and no published intervention studies; (4) incorporating self‐care strategies into clinical psychology training is recommended; and (5) “third‐wave” cognitive behaviour therapy stress management interventions have been efficacious in comparable populations. In view of the potential costs of elevated stress to trainees themselves and their clients, research on stress and stress management in this population is of a high priority. Broad research agendas are proposed for these two domains. Modifications to clinical training programmes to reduce trainee stress are required and should be evidence‐based and systematically revaluated.     

Personalized and not general suggestion produces false autobiographical memories and suggestion-consistent behavior

Suggesting false childhood events produces false autobiographical beliefs, memories and suggestion-consistent behavior. The mechanisms by which suggestion affects behavior are not understood, and whether false beliefs and memories are necessary for suggestions to impact behavior remains unexplored. We examined the relative effects of providing a personalized suggestion (suggesting that an event occurred to the person in the past), and/or a general suggestion (suggesting that an event happened to others in the past). Participants (N=122) received a personalized suggestion, a general suggestion, both or neither, about childhood illness due to spoiled peach yogurt. The personalized suggestion resulted in false beliefs, false memories, and suggestion-consistent behavioral intentions immediately after the suggestion. One week or one month later participants completed a taste test that involved eating varieties of crackers and yogurts. The personalized suggestion led to reduced consumption of only peach yogurt, and those who reported a false memory showed the most eating suppression. This effect on behavior was equally strong after one week and one month, showing a long lived influence of the personalized suggestion. The general suggestion showed no effects. Suggestions that convey personal information about a past event produce false autobiographical memories, which in turn impact behavior.     

Offline improvement occurs for temporal stability but not accuracy following practice of integer and non-integer rhythms

Procedural learning benefits from memory processes occurring outside practice resulting in offline learning. Offline gains have been demonstrated almost exclusively for the ordinal structure of sequential motor tasks. Many skills also demand that the correct serial order of events be appropriately timed. Evidence indicates that the temporal aspect of a procedural skill can be encoded independent of serial order knowledge and governed by at least two distinct neural circuits. The present experiment determined if (a) offline gains emerge for temporal learning, and (b) if such gains occur for timing supervised by distinct timing systems. Participants experienced 216 practice trials of a 7-key press sequence that involved integer- or non-integer timing rhythms. Twenty-four hours after training 30 test trials were administered. Results revealed robust offline enhancement for timing performance of the non-integer based temporal sequences. This improvement was localized to stabilization of the required relative but not absolute time profiles. The neural circuitry central to supporting the performance of non-integer timing sequences is also a principal constituent of what is described as the "cognitive" timing system. Timing governed by this system appears most susceptible to offline gains via consolidation.     

Nonsymbolic numerical magnitude comparison: reliability and validity of different task variants and outcome measures, and their relationship to arithmetic achievement in adults

The numerical ratio effect (NRE) and the Weber fraction (w) are common metrics of the precision of the approximate numbers sense (ANS), a cognitive mechanism suggested to play a role in the development of numerical and arithmetic skills. The task most commonly used to measure the precision of the ANS is the numerical comparison task. Multiple variants of this task have been employed yet it is currently unclear how these affect metrics of ANS acuity, and how these relate to arithmetic achievement. The present study investigates the reliability, validity and relationship to standardized measures of arithmetic fluency of the NRE and w elicited by three variants of the nonsymbolic number comparison task. Results reveal that the strengths of the NRE and w differ between task variants. Moreover, the reliability and validity of the reaction time NRE and the w were generally significant across task variants, although reliability was stronger for w. None of the task variants revealed a correlation between ANS metrics and arithmetic fluency in adults. These results reveal important consistencies across nonsymbolic number comparison tasks, indicating a shared cognitive foundation. However, the relationship between ANS acuity and arithmetic performance remains unclear.     

Validity of a brief interview for assessing reflective function

The Reflective Function Scale was developed by Fonagy and colleagues (1998) to empirically measure the capacity to mentalize thoughts, intentions, feelings, and beliefs about oneself and others. Reflective Function (RF) has been reliably measured by the Adult Attachment Interview (AAI; Main and Goldwyn 1998), but its length (45-90 minutes) and the labor required to administer, transcribe, and code for RF may be prohibitive for many research studies. The present study measured the reliability and validity of the Brief Reflective Function Interview (BRFI; Rudden, Milrod, and Target 2005) by administering it to 27 undergraduate participants previously assessed using the AAI in another research study (Morrison 2010). The BRFI was coded reliably by two independent raters (ICC = .79) and yielded a highly significant positive correlation (r = .71) between RF scores obtained by BRFI and by AAI. The average administration time of the BRFI (M = 24.15 minutes) was significantly shorter than that of the AAI (M = 44.65 minutes). These findings suggest that the BRFI may offer a reliable, valid, and streamlined alternative to the AAI as a measure for coding RF.     

The compensation and capitalization models: A test of two approaches to individualizing the treatment of depression

Despite long-standing calls for the individualization of treatments for depression, modest progress has been made in this effort. The primary objective of this study was to test two competing approaches to personalizing cognitive-behavioral treatment of depression (viz., capitalization and compensation). Thirty-four adults meeting criteria for Major Depressive Disorder (59% female, 85% Caucasian) were randomized to 16-weeks of cognitive-behavioral treatment in which strategies used were selected based on either the capitalization approach (treatment matched to relative strengths) or the compensation approach (treatment matched to relative deficits). Outcome was assessed with a composite measure of both self-report (i.e., Beck Depression Inventory) and observer-rated (i.e., Hamilton Rating Scale for Depression) depressive symptoms. Hierarchical linear modeling revealed a significant treatment approach by time interaction indicating a faster rate of symptom change for the capitalization approach compared to the compensation approach (d = .69, p = .03). Personalizing treatment to patients' relative strengths led to better outcome than treatment personalized to patients' relative deficits. If replicated, these findings would suggest a significant change in thinking about how therapists might best adapt cognitive-behavioral interventions for depression for particular patients.     

Longitudinal study of low and high achievers in early mathematics

Background. Longitudinal studies allow us to identify, which specific maths skills are weak in young children, and whether there is a continuing weakness in these areas throughout their school years. Aims. This 2‐year study investigated whether certain socio‐demographic variables affect early mathematical competency in children aged 5–7 years. Sample. A randomly selected sample of 127 students (64 female; 63 male) participated. At the start of the study, the students were approximately 5 years old (M= 5.2; SD= 0.28; range = 4.5–5.8). Method . The students were assessed using the Early Numeracy Test and then allocated to a high (n= 26), middle (n= 76), or low (n= 25) achievers group. The same children were assessed again with the Early Numeracy Test at 6 and 7 years old, respectively. Eight socio‐demographic characteristics were also evaluated: family model, education of the parent(s), job of the parent(s), number of family members, birth order, number of computers at home, frequency of teacher visits, and hours watching television. Results . Early Numeracy Test scores were more consistent for the high‐achievers group than for the low‐achievers group. Approximately 5.5% of low achievers obtained low scores throughout the study. A link between specific socio‐demographic characteristics and early achievement in mathematics was only found for number of computers at home. Conclusions . The level of mathematical ability among students aged 5–7 years remains relatively stable regardless of the initial level of achievement. However, early screening for mathematics learning disabilities could be useful in helping low‐achieving students overcome learning obstacles.     

Neurogenesis interferes with the retrieval of remote memories: Forgetting in neurocomputational terms

In contrast to models and theories that relate adult neurogenesis with the processes of learning and memory, almost no solid hypotheses have been formulated that involve a possible neurocomputational influence of adult neurogenesis on forgetting. Based on data from a previous study that implemented a simple but complete model of the main hippocampal circuitry (Weisz & Argibay, 2009), we now test this model under different situations to better study the case of remote memories. The results of this work show that following neurogenesis, the new, ongoing memories in the hippocampus are better retained than when no neurogenesis occurs at all, while the older memories are affected (to a lesser extent) by a special type of interference that is different from interference that occurs with an increasing number of memories per se. This work adds a new point of analysis in support of the interference view that might lead to the forgetting of memories in the hippocampus as they are transferred to neocortex for long-term storage, consistent with the Complementary Learning Systems models of system-level consolidation. Attention should be directed to the specific causes of interference; the results of this work signal a type of distortion of remote memories that is produced by the birth and the growth of new processing units, which results in a subtly impoverished retrieval as new neurons become active. The proposals of this model fit well with some empirical findings that are related to the issue. In the future, as new evidence emerges, we believe that this biological process, which is largely related to learning and memory, will also help to shape our ideas about normal forgetting and its possible contributions to system consolidation.