Implementation of DBT-Informed Therapy at a Rural University Training Clinic: A Case Study

University training clinics offer state-of-the-art treatment opportunities for clients, particularly for underserved and underinsured client populations. Little has been published regarding the implementation of Dialectical Behavior Therapy (DBT) in settings such as a university training clinic, which may face challenges in utilizing such a comprehensive treatment. This single-case study describes the application of a DBT-informed treatment with a female BPD client, highlighting how the modifications made can ease implementation in a rural university training clinic. Data collected from DBT diary cards document minimal time demands required for the use of between session-coaching, along with clinically meaningful changes in suicidality and misery ratings, and effective DBT skill use. A discussion of the unique components and contributions of this case to informing potential DBT modifications within university clinics are presented.     

Planning and control of sequential rapid aiming in adults with Parkinson's disease

Eight people with Parkinson's disease (PD), 8 age-matched older adults, and 8 young adults executed 3-dimensional rapid aiming movements to 1, 3, 5, and 7 targets. Reaction time, flight time, and time after peak velocity to the 1st target indicated that both neurologically healthy groups implemented a plan on the basis of anticipation of upcoming targets, whereas the PD group did not. One suggested reason for the PD group's deficiency in anticipatory control is the greater variability in their initial force impulse. Although the PD group scaled peak velocity and time to peak velocity similarly to the other groups, their coefficients of variation were greater, making consistent prediction of the movement outcome difficult and thus making it less advantageous to plan too far in advance. A 2nd finding was that the PD group exhibited increased slowing in time after peak velocity in the final segments of the longest sequence, whereas the other 2 groups did not. The increased slowing could be the result of a different movement strategy, increased difficulty modulating the agonist and antagonist muscle groups later in the sequence, or both. The authors conclude that people with PD use more segmented planning and control strategies than do neurologically healthy older and young adults when executing movement sequences and that the locus of increased bradykinesia in longer sequences is in the deceleration phase of movement.     

Professional Online Support Group Facilitators: Guarantors of Maximal Group Utility

Synchronous online support groups (OSGs) represent a promising psychosocial resource, as they offer many of the same therapeutic factors as face-to-face groups as well as unique benefits (e.g., anonymity, convenience). Despite their advantages, OSGs also present challenges to participation, including lack of visual cues, disjointed text communication, and rapid pace, which render the presence of a professional facilitator especially important. This study involved an in-depth qualitative analysis of 38 sessions of four time-limited OSGs for informal caregivers (i.e., family) of patients with advanced-stage cancer. Results depict the ways in which four trained facilitators maximized the utility of their respective online groups—namely, by structuring and guiding, actively scanning, and modulating experiencing. These findings expand our limited understanding of the facilitative processes that take place in OSGs and may be clinically informative to professionals with an interest in this relatively novel group modality.     

Metacognition and proofreading: the roles of aging,motivation, and interest

The current study examined younger and older adults’ error detection accuracy, prediction calibration, and postdiction calibration on a proofreading task, to determine if age-related differences would be present in this type of common error detection task. Participants were given text passages, and were first asked to predict the percentage of errors they would detect in the passage. They then read the passage and circled errors (which varied in complexity and locality), and made postdictions regarding their performance, before repeating this with another passage and answering a comprehension test of both passages. There were no age-related differences in error detection accuracy, text comprehension, or metacognitive calibration, though participants in both age groups were overconfident overall in their metacognitive judgments. Both groups gave similar ratings of motivation to complete the task. The older adults rated the passages as more interesting than younger adults did, although this level of interest did not appear to influence error-detection performance. The age equivalence in both proofreading ability and calibration suggests that the ability to proofread text passages and the associated metacognitive monitoring used in judging one’s own performance are maintained in aging. These age-related similarities persisted when younger adults completed the proofreading tasks on a computer screen, rather than with paper and pencil. The findings provide novel insights regarding the influence that cognitive aging may have on metacognitive accuracy and text processing in an everyday task.     

Suicidal ideation and its recurrence in boys and men from early adolescence to early adulthood: an event history analysis

Occurrence and recurrences of suicidal ideation (SI) were modeled among boys/men assessed annually from ages 12 to 29 years. Multiple-spell discrete-time event-history analyses permitted (a) determination of whether risk for SI escalates with prior experiences of SI (spell effects), while (b) accounting for changes in risk with time (period effects) and (c) controlling for vulnerability factors. Self-reported SI (presence/absence in past week), depressive symptoms, alcohol/substance use, antisocial behavior, and official arrest records were collected annually from 205 boys recruited on the basis of community risk for delinquency. Parents' self-reported psychopathology and SES were collected in childhood. Period effects supported decreasing risk for SI over time. Spell and time-varying 1-year lagged substance use and depressive symptoms independently predicted increased risk for SI. Models involving SI with intent were explored. Consistent with interpersonal psychological theory, risk for young men's SI increases with past experience of SI, even with key propensities controlled. However, risk also decays over time. Targeting conditions that confer risk for SI is essential. Preventing and delaying SI occurrence and recurrence may represent independent mechanisms by which prevention efforts operate.     

Intergenerational and Partner Influences on Fathers’ Negative Discipline

Recent studies have found significant but relatively modest associations in parenting across generations, suggesting additional influences on parenting beyond experiences in the family of origin. The present prospective, cross-generational study of at-risk men (Oregon Youth Study) focuses on fathers' negative discipline practices with their 2- to 3-year-old children. The theoretical model is based on a dynamic developmental systems approach to problematic family functioning, which points to the importance of developmental systems, including family risk context and key influential social interactional systems, and emphasizes influence that is directly pertinent to the outcome of interest. Path modeling indicated that the men's poor and harsh discipline practices were predicted by partners' problem behavior (substance use and antisocial behavior) and negative discipline practices, as well as by poor discipline experienced in the family of origin; men's own problem behavior, ages at which they became fathers, and family socioeconomic status were controlled. Findings indicate the importance of focusing on influence dynamics across parents.     

Protean and boundaryless careers as metaphors

The terms “protean career” and “boundaryless career” are metaphors. This paper outlines the nature of metaphor and its use in contemporary social science, particularly in the study of careers. It identifies five characteristics of metaphors, which serve as a guide to analyzing and evaluating them. These are (1) literal and figurative meaning; (2) elaboration in theory; (3) external understanding; (4) relationship to other metaphors; and (5) accuracy and constructiveness. The protean and boundaryless career metaphors are examined in relation to each characteristic. Both concepts have developed in understanding outside their literal and figurative meaning. Both however appear functional in the current shifting careers environment. Suggestions are made for the further development of the concepts.