The Role of Avoidance in Complicated Grief: A Detailed Examination of the Grief-Related Avoidance Questionnaire (GRAQ) in a Large Sample of Individuals with Complicated Grief

Grief-related avoidance is a significant component of complicated grief, yet has rarely been formally measured in a validated fashion. Further, more work is needed to understand the impact of grief-related avoidance on symptom severity and functional impairment among individuals with complicated grief (CG). The Grief-Related Avoidance Questionnaire (GRAQ; Shear, Monk et al. 2007) was created to assess grief-related avoidance and the present analysis aimed to further develop this measure and construct by confirming the GRAQ’s psychometric properties and examining loss-related predictors of avoidance. In a sample of 393 adults with CG, we found the GRAQ had high internal consistency, with a Cronbach’s alpha of 0.89 and good convergent validity. While the EFA results suggest that the GRAQ may be unidimensional, a 3-factor model generally corresponded with the findings by (Shear, Monk et al. 2007), which suggested the presence of 3 subscales. Loss-related variables age, relationship to the deceased, and cause of death were all significant predictors of GRAQ scores. Our findings support that among individuals with complicated grief, avoidance is common, measurable and an important contributor to impairment.     

A Broader Understanding of Moral Distress

On the traditional view, moral distress arises only in cases where an individual believes she knows the morally right thing to do but fails to perform that action due to various constraints. We seek to motivate a broader understanding of moral distress. We begin by presenting six types of distress that fall outside the bounds of the traditional definition and explaining why they should be recognized as forms of moral distress. We then propose and defend a new and more expansive definition of moral distress and examine how it can enable the development of a taxonomy of moral distress.     

Speaking two languages with different number naming systems: What implications for magnitude judgments in bilinguals at different stages of language acquisition?

Differences between languages in terms of number naming systems may lead to performance differences in number processing. The current study focused on differences concerning the order of decades and units in two-digit number words (i.e., unit-decade order in German but decade-unit order in French) and how they affect number magnitude judgments. Participants performed basic numerical tasks, namely two-digit number magnitude judgments, and we used the compatibility effect (Nuerk et al. in Cognition 82(1):B25–B33, 2001) as a hallmark of language influence on numbers. In the first part we aimed to understand the influence of language on compatibility effects in adults coming from German or French monolingual and German–French bilingual groups (Experiment 1). The second part examined how this language influence develops at different stages of language acquisition in individuals with increasing bilingual proficiency (Experiment 2). Language systematically influenced magnitude judgments such that: (a) The spoken language(s) modulated magnitude judgments presented as Arabic digits, and (b) bilinguals’ progressive language mastery impacted magnitude judgments presented as number words. Taken together, the current results suggest that the order of decades and units in verbal numbers may qualitatively influence magnitude judgments in bilinguals and monolinguals, providing new insights into how number processing can be influenced by language(s).     

The Undoing Effect of Positive Emotions

Positive emotions are hypothesized to undo the cardiovascular aftereffects of negative emotions. Study 1 tests this undoing effect. Participants (n = 170) experiencing anxiety-induced cardiovascular reactivity viewed a film that elicited (a) contentment, (b) amusement, (c) neutrality, or (d) sadness. Contentment-eliciting and amusing films produced faster cardiovascular recovery than neutral or sad films did. Participants in Study 2 (n = 185) viewed these same films following a neutral state. Results disconfirm the alternative explanation that the undoing effect reflects a simple replacement process. Findings are contextualized by Fredrickson's broaden-and-build theory of positive emotions (B. L. Fredrickson, 1998).     

Analog scale,magnitude estimation,and person trade‐off as measures of health utility: biases and their correction

Subjects judged the disutility of health conditions (e.g. blindness) using one of them (e.g. blindness+deafness) as a standard, using three elicitation methods: analog scale (AS, how bad is blindness compared to blindness+deafness?); magnitude estimation (ME, blindness+deafness is how many times as bad as blindness?); and person trade‐off (PTO, how many people cured of blindness is as good as 10 people cured of blindness+deafness?). ME disutilities of the less bad condition were smallest, and AS was highest. Interleaving PTO with ME made PTO more like ME. AS disutilities were inconsistent with direct judgments of differences between pairs of conditions. ME and PTO judgments were internally inconsistent: e.g. the disutility of one‐eye‐blindness relative to blindness+deafness was larger than predicted from comparison of each to blindness. Consistency training reduced inconsistency, increased agreement between AS and PTO, and transferred from one method to the other. The results support the use of consistency checks in utility elicitation. Copyright © 2001 John Wiley & Sons, Ltd.     

Generalization of social skills to peer interactions in a child with language delays

Researchers in this study have attempted to determine whether integrating generalization promoting strategies into intervention procedures would enhance the generalization and maintenance of social skills to peer interactions in a preschoold child with language delays. This intervention took place in the natural environment of the day care facility where the child was enrolled. A multiple baseline across behaviors design addressed social response behavior, approach behavior, and play organizers. The intervention utilized a prompting and social reinforcement procedure with minimal adaptations of the onging classroom activities to systematically improve the target child's peer interactions. Several generalization promoting strategies were also used. Improvements in all three types of behavior and generalization of treatment effects across persons, settings, and time were observed. These results lend support for the value of integrating several generalization promoting strategies pre-experimentally into the intervention instead of relying on post hoc evaluation of intervention. ©1997 John Wiley & Sons, Ltd.     

Divorce mediation: the impact of mediation on the psychological well‐being of children and parents

This study evaluated levels of psychological distress experienced by children (aged 4–16) and parents at the beginning of and one month after mediation for child‐related disputes. In contrast to previous research, this study employed both child‐ and parent‐reports of child outcome. Mediation was associated with reductions in child‐reported, though not parent‐reported, child psychological distress and with reductions in parent‐reports of their own psychological distress. The negotiation of successful agreements in mediation was not related to improved psychological well‐being of family members. The difficulties encountered (i.e. small numbers, low response rate) render the results tentative. Implications of the findings for future research are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

(Emotion-centered) problem-solving therapy: An update

Problem-solving therapy (PST) is a psychosocial intervention, typically considered to be a member of the cognitive and behaviour therapies family, and is based on a biopsychosocial, diathesis-stress model of psychopathology. The overarching goal of this approach is to promote the successful adoption of adaptive problem-solving attitudes and the effective implementation of certain behaviours as a means of coping with life stressors in order to attenuate the negative effects of such events on physical and mental well-being. Over the past several decades, in addition to accumulating strong support for its efficacy as a clinical intervention, similar to many other forms of psychotherapy, PST has undergone various evolutionary changes. Developed primarily as a more cognitive-based approach, due to the large body of literature in the field of affective neuroscience that underscores the importance of the impact of affect on problem solving, PST has evolved into emotion-centered problem-solving therapy (EC-PST). This article provides for a brief excursion into the historical roots of PST and why it has evolved into EC-PST, as well as providing support for its characterisation as a transdiagnostic approach. In addition, several meta-analyses that underscore its efficacy are described, as well as the most recent clinical guidelines that comprise EC-PST.