A receiver operator characteristics analysis of treatment outcome in binge eating disorder to identify patterns of rapid response

The purpose of this study was to perform a receiver operator characteristics (ROC) analysis on a treatment sample from a randomized controlled treatment trial of participants with binge eating disorder (BED). An ROC analysis was completed with 179 adults in a 20-week treatment trial for BED to predict abstinence from binge eating at end of treatment. Percent reductions in binge eating episodes were examined following weeks 1 through 10 of treatment. The rate of percent decrease in binge eating episodes during treatment for BED was a significant predictor of clinical outcome at end of treatment. Participants who demonstrated a 15% reduction in binge eating episodes at week one were more likely to respond positively to treatment and achieve clinical remission. Findings from the current study suggest that a significant reduction in binge eating during the first week of treatment may be predictive of end of treatment remission in those with BED.     

Causal Impotence and Evolutionary Influence: Epistemological Challenges for Non-Naturalism

Two epistemological critiques of non-naturalism are not always carefully distinguished. According to the Causal Objection, the fact that moral properties cannot cause our moral beliefs implies that it would be a coincidence if many of them were true. According to the Evolutionary Objection, the fact that evolutionary pressures have influenced our moral beliefs implies a similar coincidence. After distinguishing these epistemological critiques, I provide an extensive defense of the Causal Objection that also strengthens the Evolutionary Objection. In particular, I formulate a “Master Causal Objection” featuring the controversial premise that non-naturalism can provide no adequate explanation for moral knowledge. I defend this premise by first narrowing down the range of candidate explanations to conceptual, constitutive, and evolutionary explanations, and then considering and eliminating each of these in turn.  My discussion of evolutionary explanations suggests that non-naturalists must refute the Causal Objection in order to refute the Evolutionary Objection.     

Self-appraised problem-solving skills and the prediction of secondary complications among persons with spinal cord injuries

Secondary complications following spinal cord injury (SCI) include decubitus ulcers and recurrent urinary tract infections. These conditions can significantly impair quality of life and prove life-threatening; it is also believed that these conditions are mediated by behavioral pathways. According to the social problem-solving model, persons who report effective problem-solving skills should be capable of adhering to long-term therapeutic regimens of self-care necessary to prevent these complications. We tested this assumption in the present study. Discriminant function analyses revealed self-appraised skills in approaching and defining problems contributed to the prediction of secondary complications among 53 persons with SCI. Results are discussed in light of the social problem-solving model, and the utility of problem-solving interventions in rehabilitation is explored.     

The Political Activity of Evangelical Clergy in the Election of 2000: A Case Study of Five Denominations

This article focuses on the political participation of ministers from five evangelical Protestant denominations that differ in theology, polity, and history. Despite such differences, these clergy respond to political influences in much the same fashion. We find that the standard theories of political participation have varying success in accounting for their political involvement. Sociodemographic explanations provide little help, but psychological engagement with politics has more explanatory power. Professional role orientations are the best predictors of actual participation. And the clergy who see moral reform issues as the most important confronting the country—and who hold conservative views on such issues—are most likely to become engaged. Finally, membership in Christian Right organizations serves to elicit more activity than might occur if ministers were left to internally motivated participation. Despite the emphasis on other contextual variables in some work on clerical politics, we find that communications exposures, congregational influences, and even the support of clerical colleagues have very limited independent effects on political involvement.     

A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face

OBJECTIVE: A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine. METHOD: One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood. RESULTS: Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance. CONCLUSIONS: CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.     

The impact of individual trauma symptoms of deployed soldiers on relationship satisfaction.

Research traditionally has focused on the development of individual symptoms in those who experienced trauma directly but has overlooked the interpersonal impact of trauma. The current study reports data from 45 male Army soldiers who recently returned from a military deployment to Iraq (Operation Iraqi Freedom) or Afghanistan (Operation Enduring Freedom) and their female spouses/partners. The results indicated that increased trauma symptoms, particularly sleep problems, dissociation, and severe sexual problems, in the soldiers significantly predicted lower marital/relationship satisfaction for both soldiers and their female partners. The results suggest that individual trauma symptoms negatively impact relationship satisfaction in military couples in which the husband has been exposed to war trauma.     

Neural correlates of Pavlovian conditioning in components of the neural network supporting ciliary locomotion in Hermissenda

Pavlovian conditioning in Hermissenda consists of pairing light, the conditioned stimulus (CS) with activation of statocyst hair cells, the unconditioned stimulus (US). Conditioning produces CS-elicited foot shortening and inhibition of light-elicited locomotion, the two conditioned responses (CRs). Conditioning correlates have been identified in the primary sensory neurons (photoreceptors) of the CS pathway, interneurons that receive monosynaptic input from identified photoreceptors, and putative pedal motor neurons. While cellular mechanisms of acquisition produced by the synaptic interaction between the CS and US pathways are well-documented, little is known about the mechanisms responsible for the generation or expression of the CR. Here we show that in conditioned animals light reduced tonic firing of ciliary activating pedal neurons (VP1) below their pre-CS baseline levels. In contrast, pseudorandom controls expressed a significant increase in CS-elicited tonic firing of VP1 as compared to pre-CS baseline activity. Identified interneurons in the visual pathway that have established polysynaptic connections with VP1 were examined in conditioned animals and pseudorandom controls. Depolarization of identified type I_e interneurons with extrinsic current elicited a significant increase in IPSPs recorded in VP1 pedal neurons of conditioned animals as compared with pseudorandom controls. Conditioning also enhanced intrinsic excitability of type I_e interneurons of conditioned animals as compared to pseudorandom controls. Light evoked a modest increase in IPSP frequency in VP1 of conditioned preparations and a significant decrease in IPSP frequency in VP1 of pseudorandom controls. Our results show that a combination of synaptic facilitation and intrinsic enhanced excitability in identified components of the CS pathway may explain light-elicited inhibition of locomotion in conditioned animals.     

Eating disorder and obsessive–compulsive symptoms in a sample of bulimic women: Perfectionism as a mediating factor

The present study aimed to investigate whether perfectionism mediates the association between obsessive–compulsive (OC) and eating disorder (ED) symptoms. Analyses were conducted using data collected among a national sample of eating disordered women diagnosed with BN or a subclinical variant of BN (N = 204). Each participant completed a series of self-report inventories on perfectionism, as well as OC, ED, and depressive symptoms. Higher ED symptoms were significantly associated with greater levels of perfectionism (p < .01) and OC symptoms (p < .05). As hypothesized, perfectionism significantly mediated the relationship between ED and OC symptoms, controlling for depression. Findings indicate that perfectionism may be considered a shared etiological or phenomenological factor in ED and OC symptoms.