A Preliminary Study of Clinical Process in Relation to Outcome in Psychodynamic Psychotherapy for Panic Disorder

This study identified psychotherapeutic processes that relate meaningfully to psychotherapeutic outcome for patients with panic disorder undergoing Panic-Focused Psychodynamic Psychotherapy (PFPP) (Milrod et al., 1997). Subjects were 21 patients who participated in an open clinical trial of PFPP (Milrod et al., 2000; Milrod et al., 2001). The Interactive Process Assessment (IPA) (Klein, Milrod, and Busch, 1999), a process measure developed specifically to identify the process of PFPP, was used. Process-outcome relationships were calculated between process factors at early, mid, and late treatment and outcome measures at termination. Results showed that the therapist's focus on the transference late in treatment was associated with a decrease in panic symptoms. Transference focus early in the treatment, however, was correlated with an increase in related symptomatology, as measured by the HAM-A and SDS. It was unclear from the present study how focusing on panic symptomatology affected the treatment. This process might be better investigated by comparing this aspect of PFPP with alternative psychotherapies.     

Factor Structure Validation of the Alcohol Dependence Scale in a Heavy Drinking College Sample

The prevalence of alcohol use disorders in college students necessitates that adequate measures exist to assess students for abuse and dependence. The Alcohol Dependence Scale (ADS) is a continuous measure of the severity of alcohol involvement found to have a unidimensional factor structure in clinical samples. The latent factor structure of the ADS in college drinkers has not been examined and this study sought to replicate unidimensionality. Heavy college drinkers (N = 343) completed the ADS. Performance was examined using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). The CFA did not support a single factor solution. Follow-up EFA revealed a two factor structure. The first, termed “Acute Excessive Drinking” consisted of relatively commonly endorsed items relating to loss of behavioral control, blackouts, and obsessive/compulsive drinking. The second, termed “Severe Withdrawal Symptoms,” consisted of relatively infrequently endorsed items relating to withdrawal symptoms. The ADS does not appear to have the same factor structure in college and clinical samples, making it inadvisable as a linear measure of alcohol problems within a college population.     

'I remember therefore I am, and I am therefore I remember': exploring the contributions of episodic and semantic self-knowledge to strength of identity

The present research explores the relationship between the two components of autobiographical memory--episodic and semantic self-knowledge--and identity strength in older adults living in the community and residential care. Participants (N= 32) completed the autobiographical memory interview and measures of personal identity strength and multiple group memberships. Contrary to previous research, autobiographical memory for all time periods (childhood, early adulthood, and recent life) in the semantic domain was associated with greater strength in personal identity. Further, we obtained support for the hypothesis that the relationship between episodic self-knowledge and identity strength would be mediated by knowledge of personal semantic facts. However, there was also support for a reverse mediation model indicating that a strong sense of identity is associated with semantic self-knowledge and through this may enhance self-relevant recollection. The discussion elaborates on these findings and we propose a self-knowledge and identity model (SKIM) whereby semantic self-knowledge mediates a bidirectional relationship between episodic self-knowledge and identity.     

Low-frequency repetitive transcranial magnetic stimulation of the anterior temporal lobes does not dissociate social versus nonsocial semantic knowledge

Social conceptual knowledge is imperative to communicate with, interact with, and interpret human society; however, little is known about the neural basis of social concepts. Previous research has predominantly suggested that the right anterior temporal lobe (ATL) may specifically represent social conceptual knowledge, whereas the left ATL is necessary for general semantic processing. However, this view has not always been supported by empirical studies. Employing a lateralized design and two different semantic tasks and a nonsemantic control task, we aimed to clarify some of these ambiguities by potentially dissociating left from right functionality and social from nonsocial concepts, using inhibitory repetitive transcranial magnetic stimulation (rTMS) coupled with a sham and control site stimulation (N = 56). The results showed that stimulation of the left ATL led to overall faster processing times without affecting accuracy, whilst the right ATL and control groups did not significantly change in reaction times or accuracy. No difference occurred between social and nonsocial concepts after stimulation. This study is the first to show that inhibition of the left temporal lobe may improve performance on a semantic task and provides evidence that the ATLs may be lateralized in conceptual processing. The results do not confirm that the right temporal lobe is crucial for social conceptual processing, as inhibition did not significantly affect performance for social concepts.     

Predictors Of Self-Reported Physical Symptoms in Low-Income, Inner-City African American Women: The Role of Optimism, Depressive Symptoms, and Chronic Illness

In this study we examined the association of optimism and depressive symptoms with self-reported physical symptoms in 241 low-income, inner-city African American women with or without a chronic illness (HIV). Although optimism was not a unique predictor of self-reported physical symptoms over and above depressive symptoms, optimism interacted with depressive symptoms and health status. In the community sample, but not the chronically ill sample, optimism buffered the association between depressive symptoms and self-reported physical symptoms. Clinical implications and directions for future research are discussed.     

A visualization technique for Bayesian reasoning

We tested a method for solving Bayesian reasoning problems in terms of spatial relations as opposed to mathematical equations. Participants completed Bayesian problems in which they were given a prior probability and two conditional probabilities and were asked to report the posterior odds. After a pretraining phase in which participants completed problems with no instruction or external support, participants watched a video describing a visualization technique that used the length of bars to represent the probabilities provided in the problem. Participants then completed more problems with a chance to implement the technique by clicking interactive bars on the computer screen. Performance improved dramatically from the pretraining phase to the interactive‐bar phase. Participants maintained improved performance in transfer phases in which they were required to implement the visualization technique with either pencil‐and‐paper or no external medium. Accuracy levels for participants using the visualization technique were very similar to participants trained to solve the Bayes theorem equation. The results showed no evidence of learning across problems in the pretraining phase or for control participants who did not receive training, so the improved performance of participants using the visualization method could be uniquely attributed to the method itself. A classroom sample demonstrated that these benefits extend to instructional settings. The results show that people can quickly learn to perform Bayesian reasoning without using mathematical equations. We discuss ways that a spatial solution method can enhance classroom instruction on Bayesian inference and help students apply Bayesian reasoning in everyday settings.     

Implicit sequence learning: effects of level of structure, adult age, and extended practice

The influence of structure and age on sequence learning was investigated by testing 24 young and 24 older participants for 10 sessions in an alternating serial response time task in which pattern trials alternated with random trials. Individuals encountered lag-2 or lag-3 structure, and learning was measured by the difference (in response time and accuracy) between pattern and random trials. Both ages learned lag-2 structure, but the young learned more than the older participants. Only the young people learned lag-3 structure, and they did so more slowly and to a lesser degree than they learned lag-2 structure. These age deficits in higher order sequence learning after extended practice are consistent with simultaneity theory and with theories positing that age-related deficits in neuromodulation lead to less distinctive representations.