Virtual Reality and Cognitive-Behavioral Therapy for Driving Anxiety and Aggression in Veterans: A Pilot Study

Within the U.S. military, motor vehicle accidents (MVAs) are the leading cause of preventable morbidity and mortality. Prior combat exposure and anxiety symptoms are associated with risky and aggressive driving, which is responsible for over half of MVA fatalities. Therefore, interventions are needed to reduce driving anxiety and aggression in veterans in order to mitigate the public health impact of MVAs. Virtual reality exposure therapy (VRET) offers safe, controlled exposure to distressing stimuli. The current study piloted a novel virtual reality and cognitive behavioral intervention (VRET + CBT) for veterans that integrated both anxiety and anger management components. Virtual reality driving scenarios were delivered in a driving simulator and tailored for the military population. Six previously deployed veterans completed eight intervention sessions, as well as pre/post, one month follow-up and six to nine month follow-up assessments. Repeated measures ANOVAs demonstrated significant decline and large effect sizes for PTSD symptoms, driving phobia, hyperarousal in driving situations, anxiety/anger-related thoughts and behaviors, and risky driving. Hyperarousal in driving situations declined by 69%, aggressive driving declined by 29%, and risky driving declined by 21%. Treatment gains were maintained at follow-up. Recruitment, retention, immersion, simulator sickness scores, and qualitative feedback demonstrated feasibility of the intervention. Implications for future research and adaptation are discussed.     

Task and distribution sampling affect auditory category learning

There is substantial evidence that two distinct learning systems are engaged in category learning. One is principally engaged when learning requires selective attention to a single dimension (rule-based), and the other is drawn online by categories requiring integration across two or more dimensions (information-integration). This distinction has largely been drawn from studies of visual categories learned via overt category decisions and explicit feedback. Recent research has extended this model to auditory categories, the nature of which introduces new questions for research. With the present experiment, we addressed the influences of incidental versus overt training and category distribution sampling on learning information-integration and rule-based auditory categories. The results demonstrate that the training task influences category learning, with overt feedback generally outperforming incidental feedback. Additionally, distribution sampling (probabilistic or deterministic) and category type (information-integration or rule-based) both affect how well participants are able to learn. Specifically, rule-based categories are learned equivalently, regardless of distribution sampling, whereas information-integration categories are learned better with deterministic than with probabilistic sampling. The interactions of distribution sampling, category type, and kind of feedback impacted category-learning performance, but these interactions have not yet been integrated into existing category-learning models. These results suggest new dimensions for understanding category learning, inspired by the real-world properties of auditory categories.     

Understanding the Association Between Spirituality,Religiosity, and Feelings of Happiness and Sadness Among HIV-Positive Indian Adults: Examining Stress-Related Growth as a Mediator

This study examined the role of stress-related growth as a mediator of the associations between spirituality, religiosity, and feelings of happiness and sadness in a sample of 178 HIV-positive Indian adults. Results indicated that spirituality, but not religiosity, was associated with feelings of happiness and sadness. Subsequent mediation analyses indicated that stress-related growth fully mediated the relationships involving spirituality and feelings of happiness and sadness. Overall, our findings point to the importance of facilitating greater spiritual development among HIV-positive Indians, as well as promoting strategies that help them develop and apply stress-related growth coping methods in their lives.     

Leaving to Love: Filipina Caregivers and The Queer Kinship of Transnational Childcare

This article considers the affective and psychosocial dimensions of transnational childcare. It offers a transdisciplinary engagement with the subjectivity of Filipina caregivers, suggesting that the ways in which their love and care are split across borders and nations “queers” conceptions of family, childhood, and maternal obligation. Specifically, queer theories of kinship and diaspora are employed to offer an affective reading of Canada’s Caregiver Program. D. W. Winnicott’s theory of the “good enough” mother is also engaged in an effort to complicate narratives of maternal obligation, neglect, and love.     

Bidirectional Associations between Peer Victimization and Functions of Aggression in Middle Childhood: Further Evaluation across Informants and Academic Years

The current 3-wave study examined bidirectional associations between peer victimization and functions of aggression across informants over a 1-year period in middle childhood, with attention to potential gender differences. Participants included 198 children (51% girls) in the third and fourth grades and their homeroom teachers. Peer victimization was assessed using both child- and teacher-reports, and teachers provided ratings of reactive and proactive aggression. Cross-classified multilevel cross-lagged models indicated that child-reports, but not teacher-reports, of peer victimization predicted higher levels of reactive aggression within and across academic years. Further, reactive aggression predicted subsequent increases in child- and teacher-reports of peer victimization across each wave of data. Several gender differences, particularly in the crossed paths between proactive aggression and peer victimization, also emerged. Whereas peer victimization was found to partially account for the stability of reactive aggression over time, reactive aggression did not account for the stability of peer victimization. Taken together with previous research, the current findings suggest that child-reports of peer victimization may help identify youth who are risk for exhibiting increased reactive aggression over time. Further, they highlight the need to target reactively aggressive behavior for the prevention of peer victimization in middle childhood.     

“Inside out”: Appraisals for achievement emotions from constructive,positive, and negative feedback on writing

Even with the recent surge of research on achievement emotions, few studies have investigated emotions in feedback situations and the appraisals associated with such emotions. The purpose of this study was to examine emotion appraisals of constructive criticism, negative, and positive feedback, to aid us in determining whether these appraisals differed by feedback type. In a task asking them to provide open-ended responses as they imagined receiving feedback on a writing task, undergraduates (N?=?270) gave reasons for why they might experience unpleasant emotions from positive feedback and pleasant emotions from negative feedback along with reasons for both pleasant and unpleasant emotions emanating from constructive feedback. Open coding of responses yielded categories for each emotion-feedback pairing that, across all emotions, were collapsed into five appraisal categories: feedback suggests ways to improve, a mismatch between feedback and task exists, feedback targets the self or one’s ability, feedback says something about the relationship between feedback giver and receiver, and the task is judged for its value. Distributions of appraisal categories distinguished constructive feedback from positive and negative feedback. Implications are drawn for control-value theory and for classroom feedback practices.     

The Visual Spatial Learning Test: Differential impairment during the premanifest and manifest stages of Huntington's disease

Visual spatial memory was assessed using the Visual Spatial Learning Test (VSLT) in individuals with mild to moderate Huntington's disease (HD), pre‐manifest gene carriers for HD, and demographically similar controls. The VSLT has been demonstrated to be a valid, normed measure of non‐verbal memory involving minimal motoric responses. The VSLT assesses immediate and delayed memory for designs, positions of the designs, and design/position associations. The HD group was significantly impaired (p < .05) relative to both the control and Pre‐HD groups on immediate and delayed memory for the designs, positions, and design/position associations. Although there were no differences between the Pre‐HD and control groups on immediate or delayed memory for designs or positions, the Pre‐HD group was significantly impaired (p < .05) relative to the control group on immediate and delayed memory for design/position associations. The results offer novel insight into a relatively unexamined memory deficit that may occur in gene carriers for HD prior to phenoconversion. The data indicate that the VSLT may be a useful measure of visuospatial memory during the premanifest and manifest stages of HD.     

The Unbearable Lightness of Being White

In this article I explore the relationship between feelings of superiority, White privilege, White guilt, and a denied White racial identity and how these dynamics are enacted in therapy between White therapist and client. I discuss the concepts of White privilege, White guilt, color-blind racial ideology, and the invisibility of Whiteness and their importance in understanding problems in White identity development. Throughout this discussion I draw implications for clinical practice and training. I conclude by suggesting a process for identifying the dynamics of privilege and power in cross-cultural interactions through the use of self-reflection.