Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Prevalence,correlates, and psychosocial outcomes of sport participation in young adult cancer survivors

Young adult cancer survivors (YACS) face unique challenges from their disease and treatments that may influence their sport participation choices as well as their psychosocial response.ObjectivesTo examine the prevalence, correlates, and psychosocial outcomes of sport participation in YACS.DesignA provincial, population-based mailed survey of 588 YACS in Alberta, Canada, was completed in May 2008 and included measures of sport participation, psychosocial health (depression, self-esteem, and stress), quality of life (QoL), and medical and demographic variables.ResultsOne third (32.5%) of YACS reported participating in a sport in the past month with the most common being golf (40.8%) and ice hockey (8.3%). YACS participating in sport reported an average frequency of 1.7 (SD = 1.0) days/week and an average duration of 119 min/session (SD = 68) for a total of 189 (SD = 164) min/week. Independent t-tests showed that YACS who participated in sport reported better psychosocial health and QoL including physical QoL (p < 0.001), mental QoL (p < 0.001), self-esteem (p < 0.001), depression (p < 0.001), and stress (p < 0.001). In multivariate regression analysis, 8.5% (p < 0.001) of the variance in sport participation was explained by being male (β = 0.17, p < 0.001), Caucasian (β = 0.15, p = 0.001), in better general health (β = 0.15, p < 0.001), and having a normal body mass index (β = ?0.10, p = 0.024).Discussion/conclusionsSport participation is associated with better psychosocial health and QoL in YACS but only a third participated in the past month. Randomized controlled trials examining sport as an intervention strategy to increase physical activity and improve health outcomes in YACS are warranted.     

具有类属知识性的思维:群体区别判断过程中的复杂性、有效性、有用性和实质性

类属性思维(stereotypes)在一定的程度上是对群体区别正确反映的类属信仰.类属性思维比我们一般假想的更为复杂.首先,我们在本论文中探讨了在立体性的类属性思维EPA理论框架之下的多维度,即类属性思维的三维度:评估、激活和准确度.同时还特别讨论了类属性思维与具体集体共识的表征特点的图腾信仰之间的密切关系.其次,对于作为人类信仰一部分的类属性思维准确性莫衷一是的研究,我们进行了全面综述,并且本文还仔细考查文化类属性思维,个体类属性思维,个体与群体的判断,准确性评判的标准,和原分析的数据等等,同时进一步表明类属性思维和客观现实性有密不可分的关系.最后,我们指出类属性思维对解释群体和民族的区别非常重要,特别是人的感知的实质性寓于实在的客观群体本身(“感知的同一性”).我们认为,类属性思维的过程,对于高度的实体性和感知的实质性的群体来说,具有深刻影响,况且群体或部落(民族)的图腾也是其群体或民族的实体性的外在表现.尽管我们不可能解决同类属性思维的过程有关的所有争论,但我们所强调的观点是:类属性思维是人类相互影响和生存的有效类属性识别.     

The Role of Parenting in Relational Aggression and Prosocial Behavior among Emerging Adults

This study investigated the role of remembered parenting styles and parental psychological control in the prediction of relational aggression and prosocial behavior in a college student sample (N = 323). Participants’ retrospective ratings of how they were parented were related to relational aggression and prosocial behavior; however, somewhat different relationships emerged for African American and White participants. Permissive parenting, authoritative parenting, and parental psychological control predicted relational aggression. Participant race and all 3 parenting styles (authoritarian, authoritative, and permissive) predicted prosocial behavior. Participant race moderated the relationship between psychological control and prosocial behavior. Specifically, parental psychological control was inversely related to prosocial behavior for African American, but not White, participants.     

Enhanced facial symmetry assessment in orthodontists

Assessing facial symmetry is an evolutionarily important process, which suggests that individual differences in this ability should exist. As existing data are inconclusive, the current study explored whether a group trained in facial symmetry assessment, orthodontists, possessed enhanced abilities. Symmetry assessment was measured using face and nonface stimuli among orthodontic residents and two control groups: university participants with no symmetry training and airport security luggage screeners, a group previously shown to possess expert visual search skills unrelated to facial symmetry. Orthodontic residents were more accurate at assessing symmetry in both upright and inverted faces compared to both control groups, but not for nonface stimuli. These differences are not likely due to motivational biases or a speed–accuracy tradeoff—orthodontic residents were slower than the university participants but not the security screeners. Understanding such individual differences in facial symmetry assessment may inform the perception of facial attractiveness.     

See an object,hear an object file: Object correspondence transcends sensory modality

An important task of perceptual processing is to parse incoming information into distinct units and to keep track of those units over time as the same, persisting representations. Within the study of visual perception, maintaining such persisting object representations is helped by “object files”—episodic representations that store (and update) information about objects' properties and track objects over time and motion via spatiotemporal information. Although object files are typically discussed as visual, here we demonstrate that object–file correspondence can be computed across sensory modalities. An object file can be initially formed with visual input and later accessed with corresponding auditory information, suggesting that object files may be able to operate at a multimodal level of perceptual processing.     

The relationship between reward and probability: Evidence that exploration may be intrinsically rewarding

ABSTRACT

The probability of an event occurring and the reward associated with the event can both modulate behaviour. Response times are decreased to stimuli that are either more rewarding or more likely. These two factors can be combined to give an Expected Value (EV) associated with the event (i.e., probability of the event x reward magnitude). In four experiments we investigate the effect of reward and probability on both saccadic and manual responses. When tested separately we find evidence for both a reward and probability effect across response types. When manipulations of reward magnitude and probability of the event were combined, the probability modulations dominated and these data were not well accounted for by the EV. However, a post-hoc model that included an additional intrinsic reward associated with responding provided an excellent account for the data. We argue that reward consists of both an explicit and intrinsic component. In our task, the saccadic and manual responses are linked to the information provided by the targets and the goals of the task, and successful completion of these is in itself rewarding. As a result, targets associated with a higher probability of being presented have a higher intrinsic reward.     

Effects of membership change on open discussion and team performance: The moderating role of team tenure

This study identified temporal conditions when membership change may enhance or diminish team functioning. Using a longitudinal repeated measures design surveying 41 R&D teams, this study examined whether team tenure moderated the relationship of membership change with open discussion and team performance. The results illustrated that increasing membership change was positively associated with both open discussion and team performance for newly formed teams, whereas this association was negative for long-serving teams. Thus, what matters is not so much whether a team's membership changes but rather whether the team's longevity supports or impedes adaptation to personnel changes.     

Social support as a mediator of religious involvement and physical and emotional functioning in a national sample of African-Americans

Researchers propose social support as one of the factors that may explain the positive relationship often observed between religious involvement and health outcomes. African-Americans are a population that tends to have higher than average levels of religious involvement and are also disproportionately impacted by most health conditions. The present study sought to determine whether social support mediates the role of religious involvement in physical and emotional functioning and depressive symptoms, among a national probability sample of African-Americans (N = 803). Study participants completed telephone interviews. We used structural equation modelling to test hypotheses based on the theoretical model. Findings suggest evidence for a mediating role of belonging and tangible support in the association between religious behaviours and physical functioning as well as depression. There was no mediational role played by appraisal support, or for emotional functioning. Implications for faith-based health promotion interventions are discussed.     

Decision-making deficits in drug addiction

Core aspects of addictive behaviour can be explained in terms of abnormal decision-making. Using recording of autonomic function during performance of two gambling tasks, Bechara et al. have recently identified three distinct neuropsychological subtypes in individuals with substance dependence. These subtypes may reflect dissociable patterns of disruption in limbic brain circuitry.