A Case Study of Cognitive-Behavioral Conjoint Therapy for Combat-Related PTSD in a Same-Sex Military Couple

Military deployments to Iraq and Afghanistan are associated with increased risk for posttraumatic stress disorder (PTSD), depression, and relationship impairment. Unfortunately, the perceived stigma associated with seeking deployment-related behavioral health care in military settings has been a significant barrier to care. Historically, active-duty military service members involved in same-sex intimate relationships have experienced further stressors and barriers to care related to additional stigma and lack of social support. Prior federal regulations excluded sexual minorities from openly serving in the military, thereby limiting the available behavioral health services for same-sex couples. Since this ban was lifted after the repeal of the U.S. policy known as "Don’t Ask, Don’t Tell" in 2010, gay and lesbian service members have increased opportunities to obtain behavioral health care. One therapy that is newly available to sexual minority military couples is Cognitive-Behavioral Conjoint Therapy (CBCT), which effectively addresses co-occurring PTSD and relationship dysfunction. This case study illustrates the use of CBCT for the treatment of deployment-related PTSD in a same-sex active-duty military couple. After completing all 15 CBCT sessions, the couple reported clinically meaningful changes in the service member’s PTSD symptoms, which was maintained at the 2-month follow-up. The results of this case study indicate that CBCT for PTSD can have positive treatment outcomes with military same-sex couples. Further clinical implications are discussed.     

Determining who to question, what to ask, and how much information to ask for: the development of inquiry in young children

To obtain reliable information, it is important to identify and effectively question knowledgeable informants. Two experiments examined how age and the ease of distinguishing between reliable and unreliable sources influence children’s ability to effectively question those sources to solve problems. A sample of 3- to 5-year-olds was introduced to a knowledgeable informant contrasted with an informant who always gave inaccurate answers or one who always indicated ignorance. Children were generally better at determining which informant to question when a knowledgeable informant was contrasted with an ignorant informant than when a knowledgeable informant was contrasted with an inaccurate informant. In some cases, age also influenced the ability to determine who to question and what to ask. Importantly, in both experiments, the strongest predictor of accuracy was whether children had acquired sufficient information; successful problem solving required integrating knowledge of who to question, what to ask, and how much information to ask for.     

A comparison of methods for teaching receptive labeling to children with autism spectrum disorders

Many early intervention curricular manuals recommend teaching auditory-visual conditional discriminations (i.e., receptive labeling) using the simple-conditional method in which component simple discriminations are taught in isolation and in the presence of a distracter stimulus before the learner is required to respond conditionally. Some have argued that this procedure might be susceptible to faulty stimulus control such as stimulus overselectivity (Green, 2001). Consequently, there has been a call for the use of alternative teaching procedures such as the conditional-only method, which involves conditional discrimination training from the onset of intervention. The purpose of the present study was to compare the simple-conditional and conditional-only methods for teaching receptive labeling to 3 young children diagnosed with autism spectrum disorders. The data indicated that the conditional-only method was a more reliable and efficient teaching procedure. In addition, several error patterns emerged during training using the simple-conditional method. The implications of the results with respect to current teaching practices in early intervention programs are discussed.     

The Effects of Instructions on Mothers’ Ratings of Child Attention-Deficit/Hyperactivity Disorder Symptoms

We examined whether instructional materials describing how to rate child ADHD symptoms would improve the accuracy of mothers’ ratings of ADHD symptoms presented in standard child behavior stimuli, and whether instructions would be equally effective across a range of maternal depressive symptoms and family incomes. A community sample of 100 mothers with 5 to 12 year old sons were randomly assigned to either receive or not receive the instructions. All mothers watched standard video recordings of boys displaying nonproblem behavior, ADHD symptoms, ADHD plus oppositional behaviors, or ADHD plus anxious behaviors, and then rated the ADHD symptoms of the boys in the videos. These ratings were compared to ratings of the boys’ ADHD symptoms made by objective coders. Results indicated an interaction such that the instructional materials improved the agreement between mothers’ and coders’ ratings, but only for mothers at lower family income levels. The instructional materials improved all mothers’ open-ended responses regarding knowledge of ADHD. All mothers rated more ADHD symptoms in boys with comorbid oppositional or anxious behaviors, and this effect was not reduced by the instructional materials. The potential utility of these instructions to improve the accuracy of ratings of child ADHD symptoms is explored.     

Exposure to maternal vs. paternal partner violence,PTSD, and aggression in adolescent girls and boys

Adolescents who witness interparental violence (IPV) are at increased risk for perpetrating aggressive acts. They are also at risk for post‐traumatic stress disorder (PTSD). In this study, we examined the relation between exposure to maternal vs. paternal physical IPV and adolescent girls' and boys' aggressive behavior toward mothers, fathers, friends, and romantic partners. We also assessed the influence of PTSD (as assessed by the Diagnostic Interview for Children and Adolescents‐IV (DICA‐IV)) on the relation between exposure to IPV and aggressive behavior. Participants were 63 girls and 49 boys, ages 13–18, consecutively admitted to a youth correctional facility or assessment facility designated to serve aggressive and delinquent youth. Structural equation modeling was used to estimate unique relations between exposure to maternal vs. paternal IPV and youth aggression in relationships. Girls who observed their mothers' aggressive behavior toward partners were significantly more aggressive toward friends. Similarly, boys who witnessed their fathers' aggression were significantly more aggressive toward friends. Adolescent girls and boys who observed aggression by mothers toward partners reported significantly higher levels of aggression toward their romantic partners. Approximately one third of our sample met PTSD criteria; the relation between exposure to parental IPV and aggression was stronger for individuals who met criteria for PTSD. The implications of understanding the relations between parents' and their daughters' and sons' use of aggression are discussed within the context of providing support for families in breaking intergenerational patterns of violence and aggression. Aggr. Behav. 32:385–395, 2006. © 2006 Wiley‐Liss, Inc.     

Adjustment following sexual abuse discovery: the role of shame and attributional style.

This study examined adjustment following sexual abuse as a function of shame and attributional style. One hundred forty-seven participants (83 children and 64 adolescents) were seen at the time of abuse discovery and again 1 year later. Once adjustment at abuse discovery was accounted for, shame and attribution style explained additional variation in subsequent adjustment, whereas abuse severity did not. A pessimistic attribution style at abuse discovery moderated the relation between severity of abuse and subsequent depressive symptoms and self-esteem. The relations between abuse severity and these outcomes were significant only at high levels of pessimistic attribution style. Of note, patterns of change in shame and attribution predicted which children remained at risk or improved in adjustment. In addition, age and gender differences were found in adjustment over time.     

Bidirectional priming in infants

In associative priming, the direct activation of one concept indirectly activates others that are associated with it, depending on the directionality of the association. We asked whether associative priming in preverbal infants is bidirectional. Infants associated a puppet imitation task with an operant train task by watching an adult model target actions on the puppet in the incidental context of the train. Later, priming of the forgotten memory of the train task reactivated the infants' memory of the puppet task (Experiment 1), and priming of the infants' forgotten memory of the puppet task reactivated their memory of the train task (Experiment 2). The finding that associative priming was bidirectional offers new insights into the nature of the mnemonic networks formed early in infancy. Additionally, the fact that the present association was formed rapidly and incidentally suggests that a fast mapping, general learning mechanism, like that posited to mediate word-object learning, was responsible for its encoding.     

Prevention of eating disorders and obesity via the internet

Internet technology has been expanding rapidly and has had a dramatic impact on how people communicate, learn and share information. This article presents applications of internet technology to the psychological domain, particularly in the prevention and treatment of eating disorders and obesity. Information regarding advantages and disadvantages of computerized interventions are discussed and several examples of randomized controlled trials with this technology are presented. The studies presented are not meant to be comprehensive of psychological interventions in general, but are examples of computerized applications from the eating disorder and obesity literatures. Ethical considerations and areas for future direction are also discussed.