Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

The impacts of ignoring individual mobility across clusters in estimating a piecewise growth model

A three-level piecewise growth model (3L-PGM) can be used to break up nonlinear growth into multiple components, providing the opportunity to examine potential sources of variation in individual and contextual growth within different segments of the model. The conventional 3L-PGM assumes that the data are strictly hierarchical in nature, where measurement occasions (level 1) are nested within individuals (level 2) who are members of a single cluster (level 3). However, in longitudinal research, it is sometimes difficult for data structures to remain purely clustered during a study, such as when some students change classrooms or schools over time. One resulting data structure in this situation is known as a multiple membership structure, where some lower-level units are members of more than one higher-level unit. The new multiple membership PGM (MM-PGM) extends the 3L-PGM to handle multiple membership data structures frequently found in the social sciences. This study sought to examine the consequences of ignoring individual mobility across clusters when estimating a 3L-PGM in comparison to estimating a MM-PGM. MM-PGM estimates were less biased (especially in the cluster-level coefficient estimates), although we found substantial bias in cluster-level variance components across some conditions for both models.     

More Aboutness in Imagination

Journal of Philosophical Logic - In Berto’s logic for aboutness in imagination, the output content of an imaginative episode must be part of the initial content of the episode (Berto, Philos...     

Racialized Religion and Judicial Injustice: How Whiteness and Biblicist Christianity Intersect to Promote a Preference for (Unjust) Punishment

America's judicial system is both exceptionally punitive and demonstrably unjust toward racial minorities. While these dual realities are structured into America's institutions, we propose they are also partially sustained by the intersection of ideologies that are both racialized and sacralized. Using multiple waves of the General Social Surveys and a unique measure that asks Americans to choose between two forms of judicial injustice (wrongful conviction or erroneous acquittal), we examine how white racial identity intersects with biblical literalism to bolster America's bent toward unjust punitiveness. In the main effects, Americans who affirm biblical literalism are more likely to show a preference for convicting the innocent, as are whites compared to Black Americans. Examining interaction effects, however, we find whiteness moderates the influence of biblical literalism such that only white biblical literalists (as opposed to non‐white biblical literalists or white non‐biblical literalists) are more likely to prefer wrongful conviction. Indeed, in our full model, being a white biblical literalist is the strongest predictor of preferring wrongful conviction. We theorize that preference for wrongful conviction over erroneous acquittal stems, at least in part, from the combination of sacralized authoritarianism and perceived racial threat.     

Redefining the Meaning of Negative History in Times of Sociopolitical Change: A Social Creativity Approach

This article explores the role negative history plays in political discourse on crisis management and how times of sociopolitical change in turn influence the strategies that can be employed to write a positive historical charter. Choosing Germany as a case study, we analyzed how political leaders negotiate Germany's narrative and political role during the European “refugee crisis” in speeches (n = 332) held between 2015 and 2018. Applying a combination of corpus-based and qualitative narrative analysis, we found that the context of a crisis is used to attach new meaning to Germany's role in World War II. By focusing on the lessons learned from history and pointing out the parallels between the current crisis and sociopolitical developments that took place 80 years ago, Germany is presented as the ideal advocate for a free and united Europe, a narrative that legitimizes its advancingly dominant role within the EU and beyond. The analysis demonstrates how times of change can facilitate social creativity strategies for nations whose past is dominated by negative history, with implications for the theory of identity management.     

Jail‐based competency treatment comes of age: Multi‐site outcomes and challenges to the implementation of an evidence‐based forensic continuum

The jail‐based competency treatment (JBCT) model has become an established forensic practice across the country. From the perspective of implementation science and the three core elements of the Promoting Action on Research Implementation in Health Service (PARiHS) framework, the JBCT model is a remarkable example of how context (an unrelenting and overwhelmingly strong demand for forensic beds) has driven multiple state governments to facilitate implementation of a methodology in the absence of empirical evidence supporting its efficacy. This 7‐year study of outcomes from four JBCT program sites provides this much‐needed evidence by showing that JBCT restored 56% of 1553 male and 336 female patients over an average of 48.7 days. At the same time, the study highlights how variations in JBCT models, methods, and preadmission stabilization time present challenges to planned and effective implementation of evidence‐based practice at the statewide system level. By identifying differential responsiveness to JBCT treatment by diagnosis and other factors, the study suggests preliminary implementation ideas for what types of patients are well served by the JBCT model as part of a continuum of restoration options that includes inpatient, outpatient and diversion. Significant findings showed that JBCT patients were restored at a higher rate and in a shorter time if they were female, < 20 years old (highest restoration rate; those < 60 years old also significantly better rates), free of co‐occurring intellectual and cognitive deficits, and malingering. Of the major diagnoses, schizoaffective disorder required a significantly longer length of JBCT treatment for restoration, and lower restoration rates than schizophrenia and bipolar disorder, although this was moderated by a significant interaction with abuse of amphetamines.     

Measuring Possessions as Extensions of Self and Links to Significant Others in Hoarding: the Possessions as Others and Self Inventory

Journal of Psychopathology and Behavioral Assessment - This paper presents the development and validation of the Possessions as Others and Self Inventory (POSI). The POSI is a 23-item self-report...     

Death Attitudes,Palliative Care Self-efficacy,and Attitudes Toward Care of the Dying Among Hospice Nurses

Journal of Clinical Psychology in Medical Settings - Previous research has linked death attitudes, palliative care self-efficacy, and attitudes toward care of the dying among nursing students and...     

A Systematic Review of Self-Report Measures of Negative Self-Referential Emotions Developed for Non-Clinical Child and Adolescent Samples

Clinical Child and Family Psychology Review - The crisis in child and adolescent mental health and wellbeing has prompted the development of school and community-based interventions to tackle...