Defining the Assessment and Treatment Competencies to Deliver Low-Intensity Cognitive Behavior Therapy: A Multi-Center Validation Study

Despite the vastly increased dissemination of the low-intensity (LI) version of cognitive behavior therapy (CBT) for the treatment of anxiety and depression, no valid and reliable indices of the LI-CBT clinical competencies currently exist. This research therefore sought to develop and evaluate two measures: the low-intensity assessment competency scale (LIAC) and the low-intensity treatment competency scale (LITC). Inductive and deductive methods were used to construct the competency scales and detailed rating manuals were prepared. Two studies were then completed. The first study used a quantitative, fully-crossed design and the second a multi-center, quantitative longitudinal design. In study one, novice, qualified, and expert LI-CBT practitioners rated an LI-CBT assessment session (using the LIAC) and an LI-CBT treatment session (using the LITC). Study two used the LIAC and LITC across four training sites to analyze the competencies of LI-CBT practitioners over time, across raters, and in relation to the actor/patients’ feedback concerning helpfulness, the alliance, and willingness to return. Both the LIAC and LITC were found to be single factor scales with good internal, test-retest reliability and reasonable inter-rater reliability. Both measures were sensitive to measuring change in clinical competence. The LIAC had good concurrent, criterion, discriminant, and predictive validity, while the LITC had good concurrent, criterion, and predictive validity, but limited discriminant validity. A score of 18 accurately delineated a minimum level of competence in LI-CBT assessment and treatment practice, with incompetent practice associated with patient disengagement. These observational ratings scales can contribute to the clinical governance of the burgeoning use of LI-CBT interventions for anxiety and depression in routine services and also in the methods of controlled studies.     

Flexible Utility Function Approximation via Cubic Bezier Splines

Psychometrika - In intertemporal and risky choice decisions, parametric utility models are widely used for predicting choice and measuring individuals’ impulsivity and risk aversion. However,...     

Perceived discrimination is associated with poorer health and well‐being outcomes among Pacific peoples in New Zealand

Our study investigated the association between perceived discrimination and outcomes related to health and well‐being for Pacific adults in New Zealand. We examined personal and group discrimination from the 2013 wave of the New Zealand Attitudes and Values Study (n = 429 women and 196 men). Personal discrimination was associated with poorer health and well‐being outcomes (higher psychological distress and lower self‐esteem, subjective evaluation of health, satisfaction with life and personal well‐being). Group discrimination, in contrast, was associated with poorer well‐being but not health outcomes (lower subjective evaluation of health and personal well‐being). These findings corroborate previous research and highlight the corrosive effect of discrimination towards health and well‐being among Pacific communities in New Zealand.     

Examining abuse in online media

While online spaces and media offer unique possibilities for participating in critical and mundane communication, these also introduce several problems in the form of abuse such as trolling, flaming, or other anti‐social behavior. Social and personality psychologists offer a range of explanations for abusive behavior online. Here we distinguish between explanations that treat online abuse as readily known and consequently proceed with examining possible causes of such abuse, and those that treat abuse as a situated act of communication worth examining in its own right. The latter examines how abuse is accomplished, treated, and negotiated in specific online settings. A central advantage of doing so is that the specifics and details of instances of abuse become amenable to examination and consequently allow for identification of in situ means by which abuse maybe challenged. In taking this approach, online abuse is examined for how it is produced and situated in specific social and interactional settings.     

Sentence processing strategies in healthy seniors with poor comprehension: an fMRI study

We used fMRI to examine patterns of brain recruitment in 22 healthy seniors, half of whom had selective comprehension difficulty for grammatically complex sentences. We found significantly reduced recruitment of left posterolateral temporal [Brodmann area (BA) 22/21] and left inferior frontal (BA 44/6) cortex in poor comprehenders compared to the healthy seniors with good sentence comprehension, cortical regions previously associated with language comprehension and verbal working memory, respectively. The poor comprehenders demonstrated increased activation of left prefrontal (BA 9/46), right dorsal inferior frontal (BA 44/6), and left posterior cingulate (BA 31/23) cortices for the grammatically simpler sentences that they understood. We hypothesize that these brain regions support an alternate, nongrammatical strategy for processing complex configurations of symbolic information. Moreover, these observations emphasize the crucial role of the left perisylvian network for grammatically guided sentence processing in subjects with good comprehension.     

Diagnosing agoraphobia in the context of panic disorder: examining the effect of DSM-IV criteria on diagnostic decision-making

A diagnostic and statistical manual (DSM)-IV diagnosis of agoraphobia in the context of panic disorder (PD) is based on three nosologically sufficient criteria: (1) avoidance, (2) use of companions, and (3) endurance of situations despite distress. Therefore, an agoraphobia diagnosis can be made across an extremely broad range of cases including when there are no avoidance behaviors (e.g., the patient endures the situation). It was hypothesized that clinicians do not weight these criteria equally and that the DSMs individual, sufficient criteria lead to poor inter-rater reliability. Clinicians (N=48) rated hypothetical patients with symptom profiles emphasizing each of these three criteria. Consistent with expectation, clinicians differentially weighted these criteria. Avoidance was relatively more apt to produce a diagnosis when only one criterion was emphasized in clinical vignettes. Inter-rater reliability was poor in instances when only one sufficient criterion was highlighted. Knowledge concerning DSM criteria resulted in a greater rate of agoraphobia endorsement, but knowledge did not account for the overall pattern of findings.     

Evaluation of behavioral measures of risk taking propensity with inner city adolescents

The current study examined the utility of behavioral measures of risk-taking propensity in the assessment of self-reported real-world risk-taking behaviors using a sample of 51 high-school-aged inner-city adolescents. Results indicated that performance on one behavioral measure, the balloon analogue risk task, accounted for unique variance in self-reported delinquency/safety risk behaviors as well as substance use risk behaviors, above and beyond that provided with demographics and self-report measures of risk-related constructs (i.e., impulsivity and sensation seeking). These results are discussed in relation to the potential utility of using a multimethod assessment approach for better understanding risk-taking vulnerability among adolescents.