Prolonged Exposure Therapy for PTSD among Individuals in a Residential Substance Use Treatment Program: A Case Series

Clients with co-occurring posttraumatic stress disorder (PTSD) and substance use disorders present a unique challenge for clinicians in substance use treatment settings. Substance dependent individuals with PTSD tend to improve less during substance use treatment and relapse more quickly following abstinence attempts compared to those without PTSD. Recent scientific efforts have focused on understanding the potential benefit of providing PTSD treatment concurrent with substance use treatment. The current case study describes 4 individuals with PTSD in a residential substance use facility who received prolonged exposure therapy for treatment of PTSD, in addition to the substance use treatment. These individuals completed 9 bi-weekly 60-minute sessions of prolonged exposure, as well as in vivo and imaginal exposure homework between sessions. None of the clients met criteria for PTSD at the end of treatment, with these gains being maintained at 3- and 6-months post-treatment. Additionally, the clients did not relapse in response to undergoing exposure therapy. Implications for delivery of PTSD treatment in substance use treatment facilities are discussed.     

Patient and partner correlates of couple relationship functioning in bipolar disorder

Extensive research in unipolar depressed and population-based samples has shown cross-partner associations between depressive symptoms and relationship adjustment. Yet despite evidence that bipolar disorder (BPD) is a more chronic and severe illness than unipolar depression, that individuals with BPD are at risk for interpersonal dysfunction, and that critical, unsupportive relationships are predictive of the course of depressive symptoms in BPD, there have been limited efforts to understand the correlates of relationship functioning within BPD. The current study addresses this gap in the literature by examining the associations between the depressive and manic symptoms of individuals with BPD, their partner's depressive symptoms, and relationship functioning, using a multimethod, multi-informant approach. Results revealed that the depressive symptoms of the individual with BPD were associated with poorer relationship functioning, particularly when the partner without BPD also had elevated depressive symptoms. In addition, an interaction between the individual with BPD's depressive and manic symptoms was observed, such that manic symptoms were associated with increased observed hostility and poorer partner relationship adjustment, but only when depressive symptoms were also elevated. These effects persisted even after overall mental health of both partners was controlled.     

The Role of Person Characteristics in Perceptions of the Validity of Cognitive Ability Testing

Individuals vary in how they perceive cognitive ability tests; thus, it is useful for organizations to consider how individual differences influence applicant perceptions of selection tools. The present study examined the influence of implicit theories of ability and locus of control on perceptions of face validity and predictive validity for two cognitive ability tests. Relationships between perceptions and test experience, job‐relevant experience, and job familiarity were also examined. Interactions between implicit theories and self‐assessed performance in predicting perceptions were found, although not of the form hypothesized. Furthermore, job familiarity and prior success in selection contexts were related to perceptions. Finally, sample type interacted with test type to influence perceptions. Implications for selection system design and research on applicant perceptions are discussed.     

Cultural Variations in Mothers’ Acceptance of and Intent to Use Behavioral Child Management Techniques

We examined cultural differences in mothers’ acceptance of and intent to use behavioral parenting techniques for managing disruptive child behavior, and the possible roles of parenting styles and implicit theories in explaining these cultural differences. A community sample of 117 Euro-Canadian and Chinese-immigrant mothers of boys aged 4- to 8-years participated. Chinese-immigrant mothers had more favorable attitudes towards punishment techniques (i.e., overcorrection and spanking) than Euro-Canadian mothers, and mothers’ authoritarian parenting style accounted for this cultural difference. No cultural differences were found in mothers’ attitudes towards reward (i.e., praise and token economy) or withdrawal of positive reinforcement (i.e., response cost and time-out). This study helps to inform efforts to increase the cultural sensitivity of mental health services for the underserved population of Chinese-immigrant families.     

Post-training unilateral amygdala lesions selectively impair contextual fear memories

The basolateral amygdala (BLA) and the dorsal hippocampus (dHPC) are both structures with key roles in contextual fear conditioning. During fear conditioning, it is postulated that contextual representations of the environment are formed in the hippocampus, which are then associated with foot shock in the amygdala. However, it is not known to what extent a functional connection between these two structures is required. This study investigated the effect on contextual and cued fear conditioning of disconnecting the BLA and dHPC, using asymmetrically placed, excitotoxic unilateral lesions. Post-training lesions selectively impaired contextual, but not cued, fear, while pretraining lesions resulted in a similar but nonsignificant pattern of results. This effect was unexpectedly observed in both the contralateral disconnection group and the anticipated ipsilateral control, which prompted further examination of individual unilateral lesions of BLA and dHPC. Post-training unilateral dHPC lesions had no effect on contextual fear memories while bilateral dHPC lesions and unilateral BLA lesions resulted in a near total abolition of contextual fear but not cued conditioned fear. Again, pretraining unilateral BLA lesions resulted in a strong but nonsignificant trend to the impairment of contextual fear. Furthermore, an analysis of context test-induced Fos protein expression in the BLA contralateral to the lesion site revealed no differences between post-training SHAM and unilateral BLA lesioned animals. Therefore, post-training unilateral lesions of the BLA are sufficient to severely impair contextual, but not cued, fear memories.     

Working within an Individual Zone of Optimal Functioning (IZOF) framework: Consultant practice and athlete reflections on refining emotion regulation skills

Objective

To examine how working within Hanin’s (2000a) Individual Zone of Optimal Functioning theoretical model (IZOF) informs intervention development for enhancing athletes’ emotion regulation skills.

Design

A single case study design was adopted to examine the applied process of facilitating a female university cross-country runner’s emotion regulation skills.

Method

Consultant reflections followed Boud’s (2001) reflective learning model for immediate and delayed reflection that informed an action research narrative organized round Kellmann and Beckmann’s (2003) action research cycle. A social validation interview was conducted following program completion to examine the athlete’s responses to the emotion regulation intervention.

Results

Consultant’s professional practice decisions and action taken to support the intervention are highlighted. Specifically, the employment and extension of Hanin’s (2000c) IZOF profiling process to inform the development of athlete skills in emotion regulation are described. Moreover, how the content and intensity of performance related subjective emotion, physiological symptom, and cognitive zone profiles for optimal performance guided the identification and enhancement of techniques contributing to effective emotion regulation is illustrated. Athlete interview responses support the overall efficacy of the intervention program.

Conclusion

The present case study supports the efficacy of working within an IZOF framework from a consultant perspective. Furthermore, athlete reflections suggest enhanced skills in emotion regulation were perceived to result from the intervention.