Ready or not? Stages of change as predictors of brief group therapy outcome in bulimia nervosa

Although group therapy is often recommended for the treatment of bulimia nervosa, relatively little is known about predictors of short-term outcome. This pilot study examined whether a standardized measure of readiness for change might be related to changes in binge frequency. Sixteen bulimic patients participated in short-term cognitive behavioral group therapy for twelve weeks. Each patient completed the Change Assessment Scale prior to treatment, along with a battery of symptom measures which were readministered at the conclusion of therapy. Bulimic patients with positive outcome in binge frequency were at a higher stage of readiness for change at pretreatment than were patients with negative outcome. Results indicated that there may be methods of determining who would be most likely to benefit from cognitive behavioral group therapy, and tentatively suggest that interventions may be more successful when readiness for change is taken into consideration.     

Newcomer Information Seeking: Individual and Contextual Influences

This study examined situational and individual influences on the proactive information seeking of newcomers. Task interdependence was expected to be positively related to information seeking, given that it links newcomers to organizational insiders. Newcomers' work related self-efficacy and the physical accessibility of organizational insiders were both predicted to moderate the relationship between task interdependence and information seeking. Usable surveys were completed by 421 co-op students (295 males and 126 females) who had been participating in career-relevant internships for approximately 4.5 weeks. All students were enrolled in an educational programme that rotates students between twelve weeks in class and twelve weeks on internship over a period of five years. Controlling for the number of previous internships and size of work group, results supported the joint moderating effect, with newcomers low on self-efficacy exhibiting greater information seeking when task interdependence and accessibility were high. Applied implications of the results and directions for future research on proactive information seeking and socialization are discussed.     

University Residence Hall Assistants as Mediators: An Investigation of the Effects of Disputant and Mediator Relationships on Intervention Preferences1

The present research investigated whether (a) preexisting affiliation (bias) between a mediator and 1 disputant and (b) interpersonal hostility between 2 disputants affected university Residence hall Assistants' (RAs') mediation strategies. Respondents (N = 45) read 1 of 4 versions of a dispute scenario; versions varied independent variables according to a 2 × 2 design (high vs. low mediator affiliation and high vs. low disputant hostility). Respondents indicated the probability of using 18 mediation techniques. Results suggested that both independent variables significantly affected strategy selection. When friends with the complainant, the RA was likely to first avoid mediating. Hostility between disputants was related to less problem solving. In all conditions. RAs mentioned techniques consistent with stage theories of mediation, moving from problem definition to problem solving to pressing the parties.     

Effects of Deviant Child Behavior on Parental Distress and Alcohol Consumption in Laboratory Interactions

Levels of adult distress and ad lib alcohol consumption following interactions with child confederates were investigated in parents of children with no diagnosable psychiatric disorders. Sixty parents (20 married couples and 20 single mothers) interacted with boys trained to enact behaviors characteristic of either normal children or deviant children with externalizing behavior disorders — attention-deficit hyperactivity disorder (ADHD), conduct disorder (CD), and oppositional defiant disorder (ODD). Relative to the normal child role, interactions with deviant confederates were rated as significantly more unpleasant, resulted in feelings of role inadequacy, and produced significantly more anxiety, depression, and hostility. After the interactions, parents were given the opportunity to drink as much of their preferred alcoholic beverage as they desired while anticipating a second interaction with the same child. The participants consumed more alcohol following exposure to deviant as opposed to normal confederates.     

Orienting and humor responses: A synthesis

Evidence is presented for a hypothesis that a humor response is an instance of a more general orienting response. The two responses both occur to stimulus novelty or incongruity and are identical behaviorally and physiologically, althouth their subjective components may differ. Evidence for the hypothesis is based on a series of paremeters that affect orienting and humor responses identically. Parameters on which the responses show strong parallels are the effects of habituation and the degree of stimulus change. Weaker parallels exist for such parameters as direction of stimulus change, number of habituation trials, stimulus complexity, salience, intensity, and the subject's arousal level. The weaker parallels are also areas in which additional humor research is needed.     

Humor as a negatively accelerated function of the degree of incongruity

The method of limits with weights was employed to determine whether a positive or inverted-U relation described the function between the degree of incongruity and indicators of humor. The degree of incongruity was defined as the difference between the mean of six previous Comparisons and a seventh heavier Comparison ranging from 250 to 7040 grams. Facial expressions and humor and surprise ratings to the seventh Comparison increased in a negatively accelerated fashion with the degree of incongruity. Downward trends in humor indicators with increased incongruity did not occur, and thus the inverted-U relation was not supported. Studies finding an inverted-U relation were interpreted as being the result of the incongruous stimulus coming from another dimension rather than from within the same dimension as the internal standard.     

Feminist and sympathetic feminist consciousness

Data from the 1976 American National Election Study were used to assess the effects of one outgroup characteristic, belief similarity—dissimilarity, on the enhancement of women's feminist consciousness. Women were focused on as the ingroup and men as the outgroup. The sample consisted of 677 women who believed that women should have an equal role with men. Outgroup belief similarity referred to women's perception that most men supported an equal role for women and outgroup dissimilarity to the perception that men did not support an equal role. Results indicated that outgroup belief similarity significantly enhanced women's feminist consciousness. Women who supported an equal role and perceived outgroup belief dissimilarity scored higher on cognitive and behavioural measures of feminist consciousness than those who supported an equal role but did not perceive outgroup dissimilarity. Secondary analyses were undertaken assessing the effect of ingroup belief similarity dissimilarity on the enhancement of sympathetic feminist consciousness among men.     

Illness and Satisfaction With Medical Care

Patients who have worse physical or mental health are less satisfied with their medical care than patients in better health. This article describes research that explores the causal underpinnings of this correlation. Does poor health cause dissatisfaction, or does dissatisfaction cause poor health? And is the dissatisfaction of sicker patients attributable to their own state of mind, or rather to how they are treated by their doctors? It appears that, predominantly, dissatisfaction follows from poorer health rather than vice versa, and moreover that sicker patients' negative outlook is a pervasive cause of their lower satisfaction. However, there is also evidence that physicians' reactions to sicker patients, in the form of curtailed social conversation, also play a role in the reduced satisfaction of these patients.     

Provider Perspectives on Outcome Goals for Children's Day Treatment

I describe service provider perspectives regarding outcome goals of children's day treatment and their ideas for how to make day treatment programs successful in achieving stated outcomes. Respondents were direct service staff from ten day treatment programs in one county in Washington state. Data were obtained through nominal group process methods. The primary outcome goals of day treatment reported were: community re-integration, improved adaptive functioning skills, psychological growth, and improved family functioning. Aspects of day treatment that may help achieve outcome targets included: team quality; comprehensive programming; a consistent, safe, accepting program environment; an individualized, developmental approach; linkages with other services; family involvement, and a low staff-to-client ratio. Outcome goals are discussed relative to those described within the research literature on children's mental health services. Implications for the use of outcome goals for quality improvement are described.