Patient Perspectives on Co-Therapists’ Behaviors in Group CBT

Journal of Contemporary Psychotherapy - Therapist behaviour influences group cohesion and the outcome of group psychotherapy. The group members make first hand observations of the therapists in...     

The effect of propensity to trust and perceptions of trustworthiness on trust behaviors in dyads

Research on trust has burgeoned in the last few decades. Despite the growing interest in trust, little is known about trusting behaviors in non-dichotomous trust games. The current study explored propensity to trust, trustworthiness, and trust behaviors in a new computer-mediated trust relevant task. We used multivariate multilevel survival analysis (MMSA) to analyze behaviors across time. Results indicated propensity to trust did not influence trust behaviors. However, trustworthiness perceptions influenced initial trust behaviors and trust behaviors influenced subsequent trustworthiness perceptions. Indeed, behaviors fully mediated the relationship of trustworthiness perceptions over time. The study demonstrated the utility of MMSA and the new trust game, Checkmate, as viable research methods and stimuli for assessing the loci of trust.     

Social anxiety and attentional biases: A top-down contribution?

Selective attention toward threatening facial expressions has been found to precipitate and maintain symptoms of social anxiety. However, the automaticity of this bias is under debate. In the present study, we aimed to test whether top-down (controlled) engagement and disengagement of attention toward threatening faces is associated with social anxiety. This was examined by testing the impact of a secondary working memory (WM) load on attentional biases. In a variation of the dot-probe task, participants’ attention was initially cued to the left or right of fixation before an upright face paired with an inverted face was presented (displaying a disgust or neutral expression), and participants responded to a subsequently presented probe. The task was performed under no-load, low-load (one-digit memory task), and high-load (six-digit memory task) conditions. Social anxiety was not found to be associated with delayed disengagement from threat. However, surprisingly, high social anxiety was associated with an engagement bias away from threat, whereas low social anxiety was associated with a bias toward threat. These results were unaffected by the WM load manipulation. This indicates that engagement with threatening facial expressions has minimal contributions from top-down mechanisms, since it is likely that orienting to facial expressions occurs relatively automatically.     

Activity engagement is related to level, but not change in cognitive ability across adulthood

It is unclear whether the longitudinal relation between activity participation and cognitive ability is due to preserved differentiation (active individuals have higher initial levels of cognitive ability), or differential preservation (active individuals show less negative change across time). This distinction has never been evaluated after dividing time-varying activity into its two sources of variation: between-person and within-person variability. Further, few studies have investigated how the association between activity participation and cognitive ability may differ from early to older adulthood. Using the PATH Through Life Project, we evaluated whether between- and within-person variation in activity participation was associated with cognitive ability and change within cohorts aged 20-24 years, 40-44 years, and 60-64 years at baseline (n = 7,152) assessed on three occasions over an 8-year interval. Multilevel models indicated that between-person differences in activity significantly predicted baseline cognitive ability for all age cohorts and for each assessed cognitive domain (perceptual speed, short-term memory, working memory, episodic memory, and vocabulary), even after accounting for sex, education, occupational status, and physical and mental health. In each case, greater average participation was associated with higher baseline cognitive ability. However, the size of the relationship involving average activity participation and baseline cognitive ability did not differ across adulthood. Between-person activity and within-person variation in activity level were both not significantly associated with change in cognitive test performance. Results suggest that activity participation is indeed related to cognitive ability across adulthood, but only in relation to the starting value of cognitive ability, and not change over time.     

Couples' cultural values, shared parenting, and family emotional climate within Mexican American families

This study tested a model of shared parenting as its centerpiece that incorporates cultural values as predictors and family emotional climate as the outcome variable of interest. We aimed to assess the predictive power of the Mexican cultural values of familismo and simpatia over couples' shared parenting practices. We anticipated that higher levels of shared parenting would predict family emotional climate. The participants were 61 Mexican American, low income couples, with at least one child between 3 and 4 years of age, recruited from a home-based Head Start program. The predictive model demonstrated excellent goodness of fit, supporting the hypothesis that a positive emotional climate within the family is fostered when Mexican American couples practice a sufficient level of shared parenting. Empirical evidence was previously scarce on this proposition. The findings also provide evidence for the role of cultural values, highlighting the importance of family solidarity and avoidance of confrontation as a pathway to shared parenting within Mexican American couples.     

POST-TRAUMATIC STRESS REACTIONS AMONGST RESCUE WORKERS AFTER A MAJOR RAIL ACCIDENT

Abstract

Rescue tasks under heavy strain may act as traumatic events creating stress reactions among the rescue workers. After a major rail accident the rescue workers were examined by questionnaire at 3 and 7 months postaccident using the General Health Questionnaire-28 (GHQ), Impact of Event Scale (IES) and a structured questionnaire made for the purpose. Eighteen percent of the 77 rescue workers who participated in the study had GHQ-case-score and 10% had IES-case-score at 7 months using the usual GHQ-cut-off (4/5) and a low IES-cut-off (19/20). For the case-scorers there was a tendency towards increased GHQ- and IES-scores from 3 to 7 months. Five (6%) had post-traumatic stress disorders (PTSD) of low to moderate severity at 7 months.     

Visual object agnosia without prosopagnosia or alexia: Evidence for hierarchical theories of visual recognition

Abstract

A single case study is presented of a patient, Mr. W, with a selective deficit in recognizing pictures and real objects, linked to impaired stored visual knowledge about objects. Despite this, Mr. W maintained a preserved ability both to read aloud printed words and to recognize famous faces, when compared with age-matched control subjects. In addition, his access to semantic information from words was superior to that from pictures. The data provide evidence that visual agnosia can occur without alexia or prosopagnosia, contrary to recent proposals (Farah 1990, 1991). This finding is consistent with a hierarchical model of visual object recognition in which agnosia can reflect impaired stored knowledge of objects without accompanying perceptual deficits. The selective recognition deficit for objects further indicates that stored knowledge concerning different classes of visual stimuli (common objects, faces, and words) is separately represented in the brain.     

Relationship between 24-Hour Ambulatory Blood Pressure and Cognitive Function in Healthy Elderly People

The idea that activity, both physical and mental, may be a protective factor against cognitive decline in later life has enjoyed currency in both the popular and general medical literature. However, considerable uncertainty remains about the relationship between activity and cognitive performance due to differing definitions of activity and to the use of select samples. The current report analysed data from a probability sample of 887 participants recruited from the community, aged 70-93 years in 1991 and followed up in 1994 and 1998. Activity was assessed using a six-item scale comprising activities that are both commonly undertaken and relevant to old age. Latent growth curves were fitted to longitudinal outcomes including activity, cognitive performance and health measures. Reduction in activity over the course of the study was observed in most participants. Substantial correlations between rates of change in activity and cognitive and health measures were observed. Decline in cognitive performance was also observed in a sub-sample of participants who maintained activity over the three waves of measurement. It was concluded that decline in mental and physical activity in older age is paralleled by decline in cognitive functioning and health. The results do not preclude the possibility that introduced modifications in activity might change the course of cognitive performance later in the life span. Further research is required to establish the causal nature of the relationship between activity and cognition.     

The Canberra Longitudinal Study: Design,Aims, Methodology,Outcomes and Recent Empirical Investigations

The first section of this paper describes methodology and major cognitive outcomes of the Canberra Longitudinal Study (CLS). This community study of 1045 Australians aged 70 years or over commenced in 1990. Participants were reassessed on three subsequent occasions. Its major themes were investigations of prevalence of dementia and depression, risk factors, inter-individual variability and instrument development. Over 60 papers arising from the study have been published.

The second section of this paper describes the use of a Factor of Curves (FOC) latent growth model to examine the existence of a common factor responsible for age-related deterioration in cognitive and non-cognitive processes. This analysis is a logical progression in a series of investigations using the Canberra Longitudinal Study into risk factors and correlates of cognitive change using structural equation modeling techniques. The FOC model is described and is used to explore the nature of an hypothesized common factor and to determine its relationship with age, gender, education, pre-morbid intelligence and to the ApoE genotype. Latent growth models were developed for each of reaction time, Symbol Letter Modalities Test (SLMT), Grip strength, self-reported Sensory disability and memory from three waves of data. Second-order latent level slope factors were established based on the individual factor growth curve models. Although a common factor model could be fitted to the data, there is little support that it represents a single common cause.     

Mentalization-based treatment of BPD

Psychoanalytically oriented partial hospital treatment for BPD has been shown to be more effective than treatment as usual in a randomized controlled trial and over 18 months of follow-up. Focus of treatment, in the context of group and individual psychotherapy, was on increasing the patient's capacity for mentalization, the capacity to think about mental states of oneself and others as separate from, yet potentially causing actions. We summarize the research and outline the essential theoretical and practical components of mentalization-based treatment. Core aspects of treatment include enhancing mentalization, bearing in mind patient deficits, using transference, retaining mental closeness, and working with current mental states. Finally, it is proposed that mentalization is a common theme in psychotherapy of BPD and may explain why different treatments "work."