Cognitive Processing Therapy for Acute Stress Disorder Resulting From an Anti-Gay Assault

This case study describes Cognitive Processing Therapy (CPT) with a 30-year-old gay man with symptoms of acute stress disorder (ASD) following a recent homophobic assault. Treatment addressed assault-related posttraumatic stress disorder symptoms and depressive symptoms. Also addressed were low self-esteem, helplessness, and high degrees of internalized homophobia. Client symptomatology was tracked using the PTSD Symptom Scale and the Beck Depression Inventory over the course of 12 sessions and for a 3-month posttermination session. Symptoms were significantly reduced by the end of the 12-week therapy and were maintained at 3-month follow-up. This case highlights the utility of this therapy in targeting both ASD symptoms and internalized homophobia relating to experiencing a hate crime-related assault. The authors elaborate on theoretical and applied issues in adapting a structured cognitive-behavioral intervention to the treatment of ASD symptoms associated with experiencing a hate crime.     

Medical Students' Motivations to Volunteer: An Examination of the Nature of Gender Differences

A sample of medical students was surveyed using the Volunteer Functions Inventory, an instrument that assesses the importance of 6 possible motives to volunteer that range from altruistic and humanitarian concern for others to more self-interested, career-related motives. Researchers in the past have described mean differences and rank differences for gender. Profile analysis was conducted to assess the relative importance of each motive by gender. Women rated all motives higher than did men. The relative ranking of the importance of the motives was similar for both genders. Contrary to previous studies, women rated instrumental motives at least as high as did men. Both genders rated altruistic motives highly. The results of this study may be used to inform a training curriculum or advertising campaign aimed at increasing volunteer efforts.     

The development of metasuggestibility in children

One component of metasuggestibility is the understanding that a person's statements can influence another person's reports. The purpose of the present study was to examine the development of this understanding in school‐aged children. We produced a short video in which a boy makes a false allegation about being hit following an adult's suggestive interview. Children aged 6–13 years (N = 196) watched the video and answered open‐ended and forced‐choice questions about why the boy made a false allegation. The 6‐ and 7‐year‐olds performed poorly on all question types, whereas the 12‐ and 13‐year‐olds were at ceiling. There were developmental increases in metasuggestibility between 8 and 11 years. Our findings indicate that metasuggestibility undergoes prolonged development well into the school years. Implications for child witness training programs are discussed. Copyright © 2010 John Wiley & Sons, Ltd.     

Age-related changes in the signal value of tears

Emotional tears may be uniquely human and are an effective signal of distress in adults. The present study explored whether tears signal distress in younger criers and whether the effect of tears on observers is similar in magnitude across the life span. Participants rated photographs of crying infants, young children, and adults, with tears digitally removed or added. The effectiveness of tears in conveying sadness and eliciting sympathy was greatest for images of adults, intermediate for images of children, and least potent for images of infants. These findings suggest that the signal value of tears varies with the age of the crier. The results may shed light on the functional significance of crying at different stages of human development.     

The impact of civility interventions on employee social behavior, distress, and attitudes

Although incivility has been identified as an important issue in workplaces, little research has focused on reducing incivility and improving employee outcomes. Health care workers (N = 1,173, Time 1; N = 907, Time 2) working in 41 units completed a survey of social relationships, burnout, turnover intention, attitudes, and management trust before and after a 6-month intervention, CREW (Civility, Respect, and Engagement at Work). Most measures significantly improved for the 8 intervention units, and these improvements were significantly greater than changes in the 33 contrast units. Specifically, significant interactions indicating greater improvements in the intervention groups than in the contrast groups were found for coworker civility, supervisor incivility, respect, cynicism, job satisfaction, management trust, and absences. Improvements in civility mediated improvements in attitudes. The results suggest that this employee-based civility intervention can improve collegiality and enhance health care provider outcomes.     

LGB-Affirmative Cognitive Behavioral Treatment for Social Anxiety: A Case Study Applying Evidence-Based Practice Principles

Guided by the American Psychological Association's principles of evidence-based practice, this article reviews a single-case treatment outcome study whereby a client characteristic, sexual identity, was integrated into the assessment and treatment of social anxiety symptoms. The case involved a young adult European-American male who presented to a training clinic with a primary diagnosis of social anxiety disorder as well as secondary symptoms of excessive worry and concerns of sexual identity confusion. Recent evidence suggests that gay men report more symptoms of social anxiety when compared to heterosexual men, and those who make more efforts to conceal their sexual identity experience increased anxiety and have greater difficulty committing to a personal identity. Further, it has been hypothesized that fear of rejection from heterosexual individuals underlies this anxiety. The client attended 50 sessions over the course of 18 months. Treatment progress was assessed via self-report questionnaires assessing social anxiety and worry. Consistent with principles of evidence-based practice, a cognitive behavioral treatment protocol was employed at the outset of therapy and resulted in a decline in the client's social anxiety scores. However, once the case conceptualization and treatment focus shifted to focus on sexual identity, his scores continued to decline at an even steeper rate. He ultimately came to identify himself as having a same-sex sexual orientation, began living his life in a manner consistent with that identification, and reported a number of positive outcomes at termination of therapy. Implications for treatment of social anxiety in sexual minorities are discussed.     

Immediate and delayed effects of word frequency and word length on eye movements in reading: a reversed delayed effect of word length

Three experiments examined the effects in sentence reading of varying the frequency and length of an adjective on (a) fixations on the adjective and (b) fixations on the following noun. The gaze duration on the adjective was longer for low frequency than for high frequency adjectives and longer for long adjectives than for short adjectives. This contrasted with the spillover effects: Gaze durations on the noun were longer when adjectives were low frequency but were actually shorter when the adjectives were long. The latter effect, which seems anomalous, can be explained by three mechanisms: (a) Fixations on the noun are less optimal after short adjectives because of less optimal targeting; (b) shorter adjectives are more difficult to process because they have more neighbors; and (c) prior fixations before skips are less advantageous places to extract parafoveal information. The viability of these hypotheses as explanations of this reverse length effect on the noun was examined in simulations using an updated version of the E-Z Reader model (A. Pollatsek, K. Reichle, & E. D. Rayner, 2006c; E. D. Reichle, A. Pollatsek, D. L. Fisher, & K. Rayner, 1998).     

The pattern of subjective anxiety during in-session exposures over the course of cognitive-behavioral therapy for clients with social anxiety disorder

Exposure-based therapies are efficacious treatments for social anxiety disorder (i.e., Gould et al., 1997). Much of the theory behind these treatments is derived from Foa and colleagues' (Foa, Huppert, & Cahill, 2005; Foa & Kozak, 1986) work on emotional processing. However, there has been little research examining individual differences in emotional processing patterns within and between treatment sessions among clients with social anxiety disorder. This study utilized longitudinal data analytic methods to examine changes in subjective anxiety during the first 3 exposure sessions in group and individual cognitive-behavioral therapy for social anxiety disorder. The results of this study provide preliminary evidence that, although anxiety generally decreases across exposures, some individuals experience considerable fluctuations in anxiety during a single exposure. Although anxiety during the first exposure was not significantly related to outcome, the relationship between anxiety during exposure and outcome became stronger during subsequent exposures. Overall, this study highlights the need to conduct more fine-grained analyses to better understand the mechanisms underlying exposure-based therapies for social anxiety disorder.     

Examining Situationally Induced State Goal Orientation Effects on Task Perceptions,Performance, and Satisfaction: A Two‐Dimensional Conceptualization1

We examined the longitudinal effects of situationally induced 2‐dimensional state goal orientations (i.e., achievement goals) on perceptions, performance, and satisfaction. Results (N = 268) indicated that high state learning cues led to higher perceived challenge and, for higher ability individuals, greater performance gains. Further, high state performance cues led to higher perceived effort. However, results revealed that state learning and performance effects were more complex than expected. State learning effects on challenge and state performance effects on effort were both stronger with other cues absent. Additionally, increasingly beneficial state learning cue effects were stronger for higher ability individuals. Thus, results provided support that state learning and performance goals are separate dimensions, and their interactive effects need further examination.     

Inference generation in young,young–old and old–old adults: evidence for semantic architecture stability

Participants (31 young, 27 young–old, and 28 old–old) read 12 narratives, pausing periodically to think aloud. The resulting protocols were analysed for 17 types of inferences and for non‐content (off‐target) information. Factor analysis yielded three inference factors: character, causal and physical. Age difference across these factors were not significant, suggesting that inferential processing architecture may be stable. Each narrative also included an unfamiliar word. Immediately following each narrative, four definition choices and a definition rating scale were presented. The definition scores of old–old adults were lower than young and young–old. In addition, definition scores were negatively related to non‐content comment counts. Taken together, these findings suggest that off‐target working‐memory intrusions may interfere with interpretation specificity in older adults even though semantic architecture remains stable. This study extends the aging and inference literature by addressing age‐related changes across categories of inferential processing and by including a sample of old–old adults. Copyright © 2007 John Wiley & Sons, Ltd.