Obsessive-compulsive disorder subtypes: an attempted replication and extension of a symptom-based taxonomy

A symptom-based subgroup taxonomy for obsessive-compulsive disorder (OCD) was evaluated and refined. The Yale-Brown Obsessive-Compulsive Scale symptom checklist was scored and cluster analysis was conducted with a sample of OCD patients (N = 114). Results were compared to Calamari et al.'s (Behaviour Research and Therapy 37 (1999) 113) five subgroup model. Rules for determining the number of subgroups supported a more complex model. In between sample comparisons, a stable contamination subgroup was found in both a five and seven subgroup taxonomy. Between sample stability was not as strong for Harming, Obsessionals, Symmetry, and Certainty subgroups. Hoarding, as a distinctive subgroup, was unstable in separate samples. When the Calamari et al. sample and the present sample were combined (N = 220), we found a reliable Hoarding subgroup. More interpretable and stable models emerged with the combined samples suggesting that large clinical samples are needed to identify OCD subgroups. Greater support was found for a seven subgroup taxonomy based subgroup interpretability and validation measure differences. The potential utility of symptom-based subgroup models of OCD and alternative approaches are discussed. Identification of reliable and valid OCD subtypes may advance theory and treatment.     

A test of psychotherapists' and nontherapists' recognition of correct and incorrect process in managing client resistance

Objective

Psychotherapist management of client resistance (i.e., opposition to change or the therapy process) has a significant impact on therapy outcomes. This study aimed at assessing psychotherapists' and nontherapists' abilities to recognise empirically supported correct and erroneous therapist responses to client resistance.

Method

Seventy-eight therapists and 111 nontherapists completed a rapidly administered novel skills test, Therapist Errors in Resistance Management (TERM), assessing recognition of correct and erroneous resistance management.

Results

Participants were, on average, less than half as accurate at recognising therapist errors (recognised below chance levels) compared with correct therapist responses to resistance (recognised above chance levels). Therapists outperformed nontherapists in accurate recognition of therapist responding. However, among the therapist group, greater clinical experience did not predict superior recognition of therapist errors.

Conclusion

These results indicate that therapists and nontherapists alike may have difficulty detecting erroneous therapist responses to resistance, tending to mistake empirically contraindicated directive responses for correct responding. This may reflect the difficult and unintuitive nature of correct resistance responding and may suggest a need for increased training in process acuity and resistance management in therapist education.     

The impact of conventional versus robust norming on cognitive characterization and clinical classification of MCI and dementia

We examined the impact of conventional versus robust normative approaches on cognitive characterization and clinical classification of MCI versus dementia. The sample included participants from the National Alzheimer's Coordinating Center Uniform Data Set. Separate demographically adjusted z-scores for cognitive tests were derived from conventional (n = 4273) and robust (n = 602) normative groups. To assess the impact of deriving scores from a conventional versus robust normative group on cognitive characterization, we examined likelihood of having a low score on each neuropsychological test. Next, we created receiver operating characteristic (ROC) curves for the ability of normed scores derived from each normative group to differentiate between MCI (n = 3570) and dementia (n = 1564). We examined the impact of choice of normative group on classification accuracy by comparing sensitivity and specificity values and areas under the curves (AUC). Compared with using a conventional normative group, using a robust normative group resulted in a higher likelihood of low cognitive scores for individuals classified with MCI and dementia. Comparison of the classification accuracy for distinguishing MCI from dementia did not suggest a statistically significant advantage for either normative approach (Z = −0.29, p = .77; AUC = 0.86 for conventional and AUC = 0.86 for robust). In summary, these results indicate that using a robust normative group increases the likelihood of characterizing cognitive performance as low. However, there is not a clear advantage of using a robust over a conventional normative group when differentiating between MCI and dementia.     

Evaluating the Utility of MFT Models in the Treatment of Trauma: Implications for Affect Regulation

The purpose of this paper is to discuss polyvagal theory as a theoretical foundation for helping clinicians more effectively treat clients who have experienced major trauma. More specifically, we emphasize that through the use of both modern and post-modern models, marriage and family therapists may use emotion regulation strategies to assist clients in overcoming the negative repercussions of traumatic events. We suggest that the nature of emotional arousal which accompanies trauma alters the physical process by which the body regulates future affective stimuli in ways that are potentially detrimental to human relationships. We then offer a discussion of how a selection of MFT models contain strategies that promote reconnection to self and others that should be utilized with greater precision, ultimately to target the physiological symptoms of trauma-altered emotion regulation processes. Finally, we discuss the need for more specific, process-oriented research that integrates cross-disciplinary theory to contribute to a more intricate and useful understanding of the treatment of trauma in the relational context.     

How Parents Still Help Emerging Adults Get Their Homework Done: The Role of Self-Regulation as a Mediator in the Relation Between Parent–Child Relationship Quality and School Engagement

Although parents are increasingly involved in their college students’ academic lives, scholars have yet to investigate parents’ role in their college students’ school engagement. We hypothesized that college students’ self-regulation would mediate the relation between parent–child relationship quality and school engagement. For the 790 undergraduates who completed questionnaires online, self-regulation mediated the relation between mother–child relationship quality and school engagement for men, and an indirect effect was found for the relation between father–child relationship quality and school engagement by way of self-regulation. Therefore, parents continue to matter in promoting their college students’ academic success.     

Group prevention of depression and anxiety symptoms

To prevent depression and anxiety, we delivered a brief, classroom-based cognitive-behavioral workshop along with ongoing Web-based materials and e-mail coaching to college students at risk for depression. At risk was defined as having mild to moderate depressive symptoms on a self-report measure of depression. Two hundred forty students were randomized into either an eight-week workshop that met in groups of 10, once per week for 2 h or into an assessment-only control group. We plan to track participants for 3 years after the workshop and here we report the 6 month preventive effects on depression and anxiety. The workshop group had significantly fewer depressive symptoms and anxiety symptoms than the control group, but there was no significant difference between the conditions on depression or anxiety episodes at 6 month follow up. The workshop group had significantly better well being than the control group, and the workshop group had significantly greater improvement in optimistic explanatory style than the control group. Improved explanatory style was a significant mediator of the prevention effects from pre- to post-workshop for depressive and anxiety symptoms, as well as for improved well being.     

Four‐year‐olds incorporate speaker knowledge into pragmatic inferences

Human communication relies on the ability to take into account the speaker's mental state to infer the intended meaning of an utterance in context. For example, a sentence such as ‘Some of the animals are safe to pet’ can be interpreted as giving rise to the inference ‘Some and not all animals are safe to pet’ when uttered by an expert. The same inference, known as a scalar implicature, does not arise when the sentence is spoken by someone with partial knowledge. Adults have been shown to derive scalar implicatures in accordance with the speaker's knowledge state, but in young children this ability is debated. Here, we revisit this question using a simple visual world paradigm. We find that both 4‐ and 5‐year‐olds successfully incorporate speaker knowledge into the derivation of scalar inferences. However, this ability does not generalize immediately to non‐linguistic communicative contexts. These findings have important implications for the development of pragmatic abilities.     

Breadwinner Seeks Bottle Warmer: How Women’s Future Aspirations and Expectations Predict Their Current Mate Preferences

Contemporary women in Western cultures are often trying to juggle careers alongside personal and societal expectations for childrearing in an effort to “have it all.” We examine the effects of this balancing act on heterosexual women’s mate selection motivations. Across three Canadian samples (n?=?360), we tested concurrent hypotheses about the desirability of both similar and complementary characteristics in a potential mate. Specifically, women’s aspirations (to prioritize career over family) and their expectations for the roles they will most likely adopt within their future partnerships (primary breadwinner and/or caregiver) were tested as key predictors of mate preferences. Although specific effects varied across samples, a mega-analysis of the combined sample and an internal meta-analysis of effect sizes from the three studies provided support for both complementary and similarity motives (controlling for gender role attitudes). Women’s aspirations to prioritize career (over family) predicted greater similarity in mate preferences, such that they placed less importance on men’s parenting qualities, more importance on their access to financial resources, and preferred a career-oriented over family-oriented exemplar. However, women’s expectations of actually taking on the breadwinner role predicted greater complementarity in mate preferences (greater desirability of parenting qualities and a family-oriented partner; with financial resources rated as less important). Our work expands current understanding of women’s decision-making processes when selecting a mate and has implications for men’s changing traits and roles.

     

Injury characteristics across functional classes of self-injurious behavior

Self-injurious behavior (SIB) is inherently problematic because it can lead to injuries, including those that are quite severe and may result in loss of function or permanent disfigurement. The current study replicated and extended Rooker et al. (2018) by classifying the physical characteristics of injuries across groups of individuals with automatically maintained SIB (ASIB Subtypes 2 and 3) and socially maintained SIB. Individuals with Subtype 2 ASIB had the most frequent and severe injuries. Further, an inverse relation was found between the level of differentiation in the functional analysis and the number of injuries across groups. Studying the response products of SIB (the injuries) documents the risks associated with SIB, justifies the need for research and the intensive intervention, and advances knowledge of SIB. Additional research is needed to replicate these findings, and determine the variables that produce different characteristics of injury secondary to SIB.