Clinical Implications for Supporting Caregivers at the End-of-Life: Findings and from a Qualitative Study

Despite families providing considerable care at end of life, there are substantial gaps in the provision of supportive care. A qualitative interview study was conducted with 17 caregivers of people supported by an adult hospice to explore the support needs of families. Family members readily identified the ways in which the diagnosis of a life-limiting illness impacted on them and the family as a whole, not just the patient. Implications for practice demonstrate the need to intervene at a family and relational level prior to bereavement, in order to mitigate complicated grief for the surviving family members. Such an approach offers a fruitful prospective alternative to supporting caregivers post-bereavement.     

Improving the future by considering the past: The impact of upward counterfactual reflection and implicit beliefs on negotiation performance

Reflecting on previous experiences and considering how things could have been better (upward counterfactual reflection) is central to learning. While researchers have identified a number of situational antecedents to upward counterfactual generation, less is known about individual differences in counterfactual reflection. We address this gap by considering how implicit beliefs regarding the fixedness or malleability of basic characteristics influence counterfactual generation. In a negotiation context, we show that individuals who believe that negotiation ability is changeable are more likely to consider how things could have been better following a negotiation experience compared to individuals who believe that negotiation ability is fixed. We further demonstrate the impact of upward counterfactual reflection on learning and performance: Negotiators who hold malleable beliefs are better able to discover creative agreements that benefit both parties in a negotiation, and these performance differences are mediated by upward counterfactual generation.     

Vulnerability-specific stress generation: an examination of depressogenic cognitive vulnerability across multiple domains

Background and Objectives: Although there is supporting evidence for the stress generation hypothesis (i.e., the tendency for depression-prone individuals to experience more negative dependent events influenced by their behaviors and characteristics), additional research is required to advance current understanding of the specific types of dependent events relevant to this effect. The present study elaborated on the stress generation hypothesis, in which the content of negative dependent events experienced by individuals is contingent upon, and matches, the nature of their particular vulnerabilities. This extension was tested within the context of Cole's competency-based model of depression. Design: Participants (n = 185) were assessed at two time-points separated by a four-month interval. Methods: Self-perceived competence in academic, social, and appearance domains at the initial time-point were examined in relation to negative life events prospectively occurring over the four-month follow-up period, assessed using the “contextual threat” method. Results: Partial support was obtained for vulnerability-specific stress generation. Stress-generation specificity was found for self-perceived competence in appearance and academic domains, but not for self-perceived social competence. Conclusions: The current findings are consistent with the possibility of a more complex relation between self-perceived social competence and domain-congruent stress generation. Individuals may be more likely to experience negative dependent events in domains matching their specific vulnerabilities.     

Reasons or rationalizations: The role of principles in the moral dumbfounding paradigm

Moral dumbfounding occurs when people maintain a moral judgment even though they cannot provide reasons for it. Recently, questions have been raised about whether dumbfounding is a real phenomenon. Two reasons have been proposed as guiding the judgments of dumbfounded participants: harm-based reasons (believing an action may cause harm) or norm-based reasons (breaking a moral norm is inherently wrong). Participants in that research (see Royzman, Kim, & Leeman, 2015), who endorsed either reason were excluded from analysis, and instances of moral dumbfounding seemingly reduced to non-significance. We argue that endorsing a reason is not sufficient evidence that a judgment is grounded in that reason. Stronger evidence should additionally account for (a) articulating a given reason and (b) consistently applying the reason in different situations. Building on this, we develop revised exclusion criteria across three studies. Study 1 included an open-ended response option immediately after the presentation of a moral scenario. Responses were coded for mention of harm-based or norm-based reasons. Participants were excluded from analysis if they both articulated and endorsed a given reason. Using these revised criteria for exclusion, we found evidence for dumbfounding, as measured by the selecting of an admission of not having reasons. Studies 2 and 3 included a further three questions relating to harm-based reasons specifically, assessing the consistency with which people apply harm-based reasons across differing contexts. As predicted, few participants consistently applied, articulated, and endorsed harm-based reasons, and evidence for dumbfounding was found.     

Zones of Proximal Emotional Development — Psychotherapy Within a Neuroaffective Perspective

This article outlines a conceptual framework for assessing personal and emotional functions of a person’s zone of proximal emotional development. The framework is based on the integrative theory Neuroaffective Developmental Psychology (NADP), which brings together attachment theory, neuropsychology, developmental psychology, and trauma theory. Within the NADP framework, this article describes a way of understanding children’s normal emotional mental organization and of examining how this mental organization may be developed or disturbed by relational issues. It also describes how a child’s mental organization can be disturbed and thus, without intervention, disturb the child’s personality development on a lifelong basis. The article presents three case vignettes, describing three children growing into adolescence with three different attachment patterns and suggested individually tailored intervention plans for each of them, relevant and useful for clinicians working with vulnerable children and families. Because the nervous system retains its plasticity throughout life, attachment is not necessarily an unchangeable pattern. That is why we as clinicians should develop psychotherapeutic methods and a research-based way of determining “what works for whom” by assessing the zone of individual proximal emotional development. The text outlines the characteristics of NADP and how it can be used to structure an intervention plan.     

The Effect of Type of Feedback in Multiple-Choice Testing on Long-Term Retention

We investigated how different types of feedback in multiple-choice testing influence long-term retention. Participants completed an initial multiple-choice test on general-knowledge questions. Then, they were randomly placed into one of the following four conditions: feedback displaying the original question and four alternative options including the correct answer (Feedback 1); feedback displaying the original question and the correct answer (Feedback 2); feedback displaying only the correct answer (Feedback 3); and no feedback (Control). On the final test two days later, participants in the feedback conditions showed improved retention—even participants who received Feedback 3 outperformed the control group, regardless of whether feedback followed correct or incorrect responses. There was no difference between the feedback conditions when feedback followed correct responses, but Feedback 1 was superior to Feedback 3 when feedback followed incorrect responses. The function of feedback in multiple-choice testing is to maintain correct responses and to correct erroneous responses.     

Naming consistency in Alzheimer''s disease

Although lexical semantic deficits are postulated to play a prominent role in the anomia of Alzheimer's disease, it is unclear whether the primary disturbance is one of lexical access or one of lexical semantic loss. Response consistency on a naming task is one means of evaluating the underlying source of naming impairment. Access dysfunction usually implies variable word-finding difficulty, while a theory of lexical loss predicts that many word names would be consistently unavailable. Nineteen Alzheimer's disease patients were administered a visual confrontation naming task (the Boston Naming Test) on two occasions 6 months apart. Eighty percent of errors occurred consistently at both times; only 20% of errors occurred on only one occasion. Response consistency occurred significantly more often than expected under the assumption of no response consistency. Findings support the hypothesis that anomia in Alzheimer's disease is in part due to a loss of lexical semantic information.     

Is the Chinese number-naming system transparent? Evidence from Chinese-English bilingual children.

Chinese-speaking children have been shown to have an advantage over English-speaking children in a variety of mathematical areas, including counting. One possible explanation for the advantage in counting is that the Chinese number-naming system is relatively transparent, compared to English, in that number names typically are directly indicative of base-10 structure (e.g., 12 is named "ten-two" rather than "twelve"). To determine whether the transparency of the Chinese number-naming system influences counting in bilingual children, we tested 25 Chinese-English bilingual children between the ages of 3 and 5 years, both in English and in Chinese. Children were asked to count as high as they could (abstract counting) and also to count objects in small, medium, and large arrays (object counting). No evidence was found for transparency or for transfer from one language to the other. Instead, relative proficiency in the two languages influenced counting skill. These results are discussed in terms of linguistic and cultural variables that might account for cross-linguistic differences in counting.