Neural correlates of rumination in depression

Rumination, or recursive self-focused thinking, has important implications for understanding the development and maintenance of depressive episodes. Rumination is associated with the worsening of negative mood states, greater affective responding to negative material, and increased access to negative memories. The present study was designed to use fMRI to examine neural aspects of rumination in depressed and healthy control individuals. We used a rumination induction task to assess differences in patterns of neural activation during ruminative self-focus as compared with a concrete distraction condition and with a novel abstract distraction condition in 14 participants who were diagnosed with major depressive disorder and 14 healthy control participants. Depressed participants exhibited increased activation in the orbitofrontal cortex, subgenual anterior cingulate, and dorsolateral prefrontal cortex as compared with healthy controls during rumination versus concrete distraction. Neural activity during rumination versus abstract distraction was greater for depressed than for control participants in the amygdala, rostral anterior cingulate/medial prefrontal cortex, dorsolateral prefrontal cortex, posterior cingulate, and parahippocampus. These findings indicate that ruminative self-focus is associated with enhanced recruitment of limbic and medial and dorsolateral prefrontal regions in depression. Supplemental materials for this article may be downloaded from http://cabn.psychonomic-journals.org/content/supplemental.     

The Farage Quality of Life Measure for Consumer Products: Development and Initial Implementation

Despite the existence of numerous health-related quality of life (HRQoL) measures, few if any are geared to evaluating the impact of consumer products. We describe the development and initial implementation of the Farage Quality of Life (FQoL™) general questionnaire, a self-administered questionnaire to assess the potential impact of a variety of consumer products on overall well-being and HRQoL. We developed the 27-item FQoL™ measure, scored on a Likert scale and covering Overall Quality of Life (1 item), Well-Being (12 items), and Energy and Vitality (14 items), and a 3-item Menstrual Module for use with menstruating women. We assessed test-retest reliability by administering the items twice to a sample of 20 women 3 days apart, calculating mean absolute differences in responses. Then, in a study of 119 women ages 18–55 years who were randomly assigned to use a new brand of menstrual pad vs. their usual menstrual pads for 1 menstrual period, we administered the FQoL™ questionnaire 5–7 days before their menstrual period and 5–7 days after the start of their period. We compared changes in responses within groups and between groups pre- vs. during menstruation. Overall, test-retest reliability was good, with a mean (SD) absolute difference for the 27 general items of 0.51 (0.31). In the menstrual pad study, the mean (SD) age of responders was 35.3 (7.9) years; 59 (50%) were age 18–35 and 60 (50%) were age 36–55. Relative to the intervention group, the usual pads group reported worse HRQoL during vs. pre-menstruation on items addressing self-confidence, managing stress, energy, and fatigue (P ≤ 0.05 for each comparison). In subgroup analyses, relative to intervention patients, women age 18-35 in the usual pads group reported greater changes for the worse during vs. pre-menstruation in managing stress; energy; and fatigue, but relatively better work or school attendance during vs. pre-menstruation, and women age 36–55 in the usual pads group reported greater changes for the worse in self-confidence and in desire to go out in public (P ≤ 0.03 for each comparison). The general FQoL™ is a new measure of HRQoL applicable to consumer product evaluation. It has good test-retest reliability. The FQoL™ menstrual module detects changes in HRQoL during vs. before the menstrual period associated with menstrual pad use. Further research is needed to assess the construct validity of the HRQoL.     

The Effect of Nonverbal Skills Training on Counselor Trainee Nonverbal Sensitivity and Responsiveness and on Session Impact and Working Alliance Ratings

Counselor trainees (N = 18) were randomly assigned to treatment (nonverbal sensitivity) or control (empathy training) conditions. Trainees saw a recruited client before (first 2 weeks) and after (last 2 weeks) a 15-week counseling methods class. Trainees rated their sensitivity to nonverbal behaviors, counseling self-efficacy, and the extent to which they focused on client nonverbal behavior. Clients filled out the Session Evaluation Questionnaire and Working Alliance Inventory at pre- and posttesting. Trained raters viewed videotapes of the counseling sessions and rated the extent that counselors focused on client nonverbal behavior. As hypothesized, trainees in the treatment condition, when compared with those in the control condition, increased their focus on client nonverbal behaviors. In addition, clients of treatment condition counselors showed significant differences in working alliance ratings. Trainees in both conditions increased their rating of nonverbal sensitivity and self-efficacy from pre- to posttesting. Implications are discussed.     

Things Unsaid in Group Counseling: An Empirical Taxonomy

Two studies were performed to examine things unsaid in group counseling. In Study 1, 28 group members described 317 things they had left unsaid during group counseling sessions. Cluster analysis identified 10 categories of things unsaid. In Study 2, the derived clusters were used by trained raters to categorize a new set of things unsaid by 28 group members. In addition, the relationships between the type of things unsaid, the stage of group development, and participant sex were examined. As hypothesized there were more advice and outside things unsaid during the orientation-inclusion stage and more positive feeling and empathic things unsaid during affection-cohesion stage of group development. There were also a number of significant interactions between participant sex and stage or group development for several categories of things unsaid. Implications for counseling are discussed.     

Career Counseling Specialty: History,Development, and Prospect

This article contains an overview of the historical development of the specialized practice, preparation standards, and credentialing of career counseling. Discussion also focuses on commonalities of career counseling, general counseling, and other specialized forms of counseling, with attention to questions and implications for the future of career counseling practice and standards.     

The 1994 ACA Model Legislation For Licensed Professional Counselors

Model legislation seeks to facilitate uniformity of counselor licensure laws and promote accepted professional standards. The text of the model bill as endorsed by the 1994 American Counseling Association Governing Council is provided with commentary accompanying those sections in which significant changes have occurred. The article concludes with 15 specific suggestions based on experiences gained in the development and implementation of previous legislation for licensed professional counselors.     

TRAINING RESIDENTIAL SUPERVISORS TO PROVIDE FEEDBACK FOR MAINTAINING STAFF TEACHING SKILLS WITH PEOPLE WHO HAVE SEVERE DISABILITIES

We evaluated procedures for training supervisors in a residential setting to provide feedback for maintaining direct-service staff members' teaching skills with people who have severe disabilities. Using classroom-based instruction and on-the-job observation and feedback, 10 supervisors were initially trained to implement teaching programs themselves. The training improved supervisors' teaching skills but was insufficient to improve the quality of feedback they provided to direct-service staff regarding the staff members' teaching skills. Subsequently, classroom-based instruction and on-the-job observation and feedback that targeted supervisors' feedback skills were provided. Following training in provision of feedback, all supervisors met criterion for providing feedback to their staff. Results also indicated that maintenance of teaching skills was greater for direct-service staff whose supervisors had received training in providing feedback relative to staff whose supervisors had not received such training. The need for analysis of other variables that affect maintenance of staff performance, as well as variables that affect other important areas of supervisor performance, is discussed.