Dialectical Behavior Therapy and Motivational Interviewing: Conceptual Convergence,Compatibility, and Strategies for Integration

Dialectical behavior therapy (DBT) and motivational interviewing (MI) are two widely used and efficacious psychosocial interventions. An immense and growing number of studies examine DBT, MI, or adaptations of these approaches across diverse treatment contexts and across various clinical populations. Because DBT and MI are in high demand, it is probable that trainees and established practitioners will encounter one or both treatments over the course of their careers. Although MI and DBT initially evolved in distinct contexts for different populations, these approaches share a number of common fundamental principles. Each provides distinct and complementary strategies for enhancing clients’ motivation and ability to change. For some, an integrative or sequenced application of MI and DBT may enhance client care. The present article highlights areas of divergence, convergence, and opportunities for integration, and offers practical tips for applying DBT and MI in conjunction.     

Perceptions of War Trauma and Healing of Marital Relations Among Torture-surviving Congolese Couples Participating in Multicouple Therapy

Citizens of the Democratic Republic of Congo (DRC) experienced widespread torture during national wars between 1998 and 2003. Couples who survived and stayed intact suffered tremendous relationship stress. This study used a critical ethnography framework to explore the prewar, wartime, and postwar experiences of 13 torture-surviving couples who participated in a 10-session Torture-Surviving Couple Group in 2008 in the DRC. The group was designed to address the relational effects of torture and war trauma. Participants reported profound negative effects of the war on their relationships; mostly positive experiences during the group, including marital and peer connection and relationship growth; and a number of improvements in their relationship after the group. Implications include support for the use of relational interventions informed by both treatments for traumatic stress and couple approaches to promote trauma healing. Future directions call for increased funding, research, training, and clinical action to treat the effects of traumatic stress on relational family dynamics.     

Factor analysis of the heterosexist harassment,rejection, and discrimination scale in lesbian,gay, bisexual,transgender, and queer people of colour

The factor structure of the Heterosexist Harassment, Rejection, and Discrimination Scale (HHRDS) was examined in lesbian, gay, bisexual, transgender, and queer (LGBTQ) people of colour. Two hundred participants completed a survey with the HHRDS and several mental health scales. A confirmatory factor analysis suggested the original HHRDS structure fit the data poorly. Exploratory factor analyses found a different 2-factor structure, consisting of harassment/rejection and family discrimination. Convergent validity analyses demonstrated that family discrimination had the largest association with depression and anxiety, indicating that family discrimination may be particularly salient among LGBTQ people of colour. This study supports the use of the HHRDS in racially/ethnically diverse samples, but with a slightly different factor structure. Examining discriminatory experiences from family members is an important direction for future research in LGBTQ people of colour.     

The father's role in the socialization of his infant

Although research on fathers and infants increased dramatically during the past decade, it did so largely in a theoretical vacuum. Theories of development emphasize mother-infant relationships, with little attention, if any, given to father-infant relationships. As a result, studies of father-infant interactions tend to replicate procedures that have been used in mother-infant research. While useful, mimicking mother-infant research paradigms may blind investigators to salient aspects of development that are unique to and critical for father-infant relationships. In traditional families, study of mother-father-infant triadic interactions may reveal more useful information about the father's role in infant socialization, than the study of father-infant dyadic interactions. However, the study of triadic interactions may yield little useful information about father-infant interaction in the single parent family. Until a number of methodological issues are resolved, the literature on the father's role in the socialization of his infant must be interpreted cautiously.     

Mapping differential responses to cognitive training using machine learning

We used two simple unsupervised machine learning techniques to identify differential trajectories of change in children who undergo intensive working memory (WM) training. We used self‐organizing maps (SOMs)—a type of simple artificial neural network—to represent multivariate cognitive training data, and then tested whether the way tasks are represented changed as a result of training. The patterns of change we observed in the SOM weight matrices implied that the processes drawn upon to perform WM tasks changed following training. This was then combined with K‐means clustering to identify distinct groups of children who respond to the training in different ways. Firstly, the K‐means clustering was applied to an independent large sample (N = 616, M_age = 9.16 years, range = 5.16–17.91 years) to identify subgroups. We then allocated children who had been through cognitive training (N = 179, M_age = 9.00 years, range = 7.08–11.50 years) to these same four subgroups, both before and after their training. In doing so, we were able to map their improvement trajectories. Scores on a separate measure of fluid intelligence were predictive of a child's improvement trajectory. This paper provides an alternative approach to analysing cognitive training data that go beyond considering changes in individual tasks. This proof‐of‐principle demonstrates a potentially powerful way of distinguishing task‐specific from domain‐general changes following training and of establishing different profiles of response to training.     

Barriers and facilitators affecting the sustainability of dialectical behaviour therapy programmes: A qualitative study of clinician perspectives

Dialectical behaviour therapy (DBT) is a psychological treatment developed for individuals experiencing chronic suicidality and high‐risk behaviours. Despite the substantial evidence supporting the effectiveness of DBT, many programmes have problems with its sustainability. The goals of the current qualitative study were to identify factors that impact the sustainability of DBT programmes within a publicly funded mental health system and identify factors that are particularly relevant for youth DBT programmes. Interviews with trained adult and youth DBT clinicians (N = 31) were conducted to explore their experiences providing DBT. Three major themes that emerged as barriers to the sustainability of DBT programmes included the following: systemic challenges, conflicts within the consultation teams and clinician burnout. Factors influencing the success of DBT programmes included the following: systemic support, clinician commitment and “buy in”, and team cohesion. Factors specific to providing DBT with youth (i.e. level of commitment, simplifying the language, and parental investment) and recommendations for sustainability for adults and youth programmes were also identified. Findings of this study provide valuable information on factors impacting DBT programmes within the unique context of a Canadian mental health service system, where community‐based services are publicly funded. These findings have clear clinical utility and can be used to generate solutions to clinicians' perceived barriers and to foster perceived facilitators within similar contexts.     

Grandparental role-meaning types: A critical evaluation

Robertson (1977), in a study of the meaning of grandparenthood, identified four distinct grandparental role-meaning types that were determined through factor analytic techniques. The purpose of the current study was to determine the usefulness of Robertson's scale and typology in assessing the meaning of grandparenthood to women and men about to assume the role. The responses of 146 subjects were analyzed, and the two factors defined by Robertson were confirmed. Subjects were categorized into Apportioned, Symbolic, Individualized, and Remote role-meaning types. Contrary to Robertson's findings, these types were not related to life style variables, such as education or age, and they did not differ in expectations for role behaviors with the grandchild. This may be due in part to the fact that before the birth of their grandchild, all four types of “expectant” grandparents must relate to the grandchild in a symbolic manner and, therefore, they may rely on normative information to predict future behavioral interactions.     

Masked priming of prefixes and the influence of spelling-meaning consistency

Two experiments are reported which examined whether a prefixed word can be primed by a word sharing only the prefix letters in a masked priming paradigm. In addition the studies examined whether the size of the priming effect is influenced by the consistency with which a prefix letter pattern appears in real prefixed words. The ratio of real prefixed words to all words containing a prefix letter pattern was calculated and used to identify high-consistency prefixes, which are frequently used as prefixes (e.g., UN in UNHAPPY) and rarely appear as pseudoprefixes (e.g., UNCLE), and low-consistency prefixes, which appear in many pseudoprefixed words (e.g., DE in DESERT) but fewer truly prefixed words (e.g., DECODE). In Experiment 1, decision latencies for both types of prefixes were facilitated when real prefixed target words were preceded by real prefixed prime words in a short SOA masked priming paradigm, although the size of the priming effect for low-consistency prefixes was similar in size to that for orthographic controls. In Experiment 2, real prefixed target words were preceded by pseudoprefixed prime words. Facilitation in performance remained for high-consistency prefixes but was absent for low-consistency prefixes. These results support models of morphological processing that are sensitive to the statistical nature of the relationships between orthographic and semantic representations in a language.     

Fabry disease in genetic counseling practice: recommendations of the National Society of Genetic Counselors

The objective of this document is to provide health care professionals with recommendations for genetic counseling and testing of individuals with a suspected or confirmed diagnosis of Fabry disease, with a family history of Fabry disease, and those identified as female carriers of Fabry disease. These recommendations are the opinions of a multicenter working group of genetic counselors, medical geneticists, and other health professionals with expertise in Fabry disease counseling, as well as an individual with Fabry disease who is a founder of a Fabry disease patient advocacy group in the United States. The recommendations are U.S. Preventive Task Force Class III, and they are based on clinical experience, a review of pertinent English-language articles, and reports of expert committees. This document reviews the genetics of Fabry disease, the indications for genetic testing and interpretation of results, psychosocial considerations, and references for professional and patient resources. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. The professional judgment of a healthcare provider, familiar with the facts and circumstances of a specific case, will always supersede these recommendations.     

How do speakers avoid ambiguous linguistic expressions?

Three experiments assessed how speakers avoid linguistically and nonlinguistically ambiguous expressions. Speakers described target objects (a flying mammal, bat) in contexts including foil objects that caused linguistic (a baseball bat) and nonlinguistic (a larger flying mammal) ambiguity. Speakers sometimes avoided linguistic-ambiguity, and they did so equally regardless of whether they also were about to describe foils. This suggests that comprehension processes can sometimes detect linguistic-ambiguity before producing it. However, once produced, speakers consistently avoided using the same linguistically ambiguous expression again for a different meaning. This suggests that production processes can successfully detect linguistic-ambiguity after-the-fact. Speakers almost always avoided nonlinguistic-ambiguity. Thus, production processes are especially sensitive to nonlinguistic- but not linguistic-ambiguity, with the latter avoided consistently only once it is already articulated.