Lay counselors: Thoughts on the crossing of ecological frameworks and the use of lay counselors in the scale up of early infant mental health interventions

The recent call for the scale-up of evidence-based early childhood development interventions, in lower and middle-income countries and for minority groups in high-income countries, has seen numerous suggestions to train greater numbers of lay mental health workers to fulfill these functions. While studies have found that concepts from developed country settings, such as attachment, parental sensitivity, and containment, find purchase and relevance within developing settings, the management of contextual and cultural factors and the tensions of cultural interfacing in the rollout of these programs in developing country settings require consideration. Drawing on the experiences of two successful South African mother–infant home-visiting programs as examples, this article discusses some of the challenges in provision of attachment-based infant mental health programs and highlights the need for careful consideration of a number of factors pertaining to the recruitment, supervision, and management of lay mental health workers before large-scale rollout is conducted.     

Decision Making with Uncertain Information: Learning from Women in a High Risk Breast Cancer Clinic

Patients and practitioners may believe that clinically validated laboratory tests provide definitive information. Genetic counselors know this is not always so, and the possibility of inconclusive genetic test results is often discussed in the pretest counseling session. This added discussion topic prolongs the process of genetic counseling, but if there is inadequate patient understanding, patient frustration may be high when receiving a result of uncertain significance, and patients may make decisions about subsequent medical management based on incorrect assumptions. For patients/participants in a research setting, where the clinical validity of testing may be unclear, some patients/participants may still want to use test results to influence their medical management. This paper presents findings from a qualitative study wherein 15 women from the High Risk Breast Cancer Clinic at Utah's Huntsman Cancer Institute discussed how uncertainty regarding results affected their decision making. The women were randomly selected from 3 categories--women with test results of uncertain significance; women without cancer who have a mutation; and women who are members of high-risk families, but for whom no mutation was found. Study findings will be used in future studies to better understand how to improve communication regarding uncertain results, especially in a research environment.     

Individual differences in metacognition: Evidence against a general metacognitive ability

Individual differences in metacognitive accuracy are generally thought to reflect differences in metacognitive ability. If so, memory monitoring performance should be consistent across different metacognitive tasks and show high test-retest reliability. Two experiments examined these possibilities, using four common metacognitive tasks: ease of learning judgments, feeling of knowing judgments, judgments of learning, and text comprehension monitoring. Alternate-forms correlations were computed for metacognitive accuracy (with a 1-week interval between tests). Although individual differences in memory and confidence were stable across both sessions and tasks, differences in metacognitive accuracy were not. These results pose considerable practical and theoretical challenges for metacognitive researchers.     

The quality of false memory over time: Is memory for misinformation “remembered” or “known”?

The conscious quality of eyewitness memory for misinformation after different retention intervals was investigated in two experiments. Participants viewed computer-projected slides depicting a crime (encoding phase), read a narrative containing misinformation, and took a recall test about the original event. Remember/know judgments were made for each response. A "remember" judgment indicated that the participant vividly recalled seeing a detail in the encoding phase. A "know" judgment indicated that the participant believed that a detail was presented but did not vividly remember it. Generally, misinformation was more likely to be associated with a know judgment than with a remember judgment after a short retention interval. This outcome suggests that, in many cases, misleading information is judged as having a different subjective quality than memory for actual events. However, over a relatively long retention interval, misinformation that simply added new information about the event was more often judged as remembered.     

Degree of representation of the matching concept in pigeons (Columba livia)

In Experiment 1, 12 pigeons (Columba livia) were trained on a simultaneous matching-to-sample task with 2 stimuli and then tested with 2 novel stimuli. Half of the birds were trained with a fixed ratio schedule requirement of 1 (FR1) or 20 (FR20) pecks on the sample stimulus. None of the birds showed any evidence of concept-mediated transfer. In Experiment 2, 12 pigeons were trained with 3 stimuli and then tested with the same novel stimuli used in Experiment 1. Half of the birds in each group were trained with either an FR1 or FR20 requirement on the sample stimulus. Two of the FR20 birds showed high levels of transfer to the novel stimuli similar to that of monkeys in a previous study.     

Hoarding behaviors in a large college sample

Hoarding behaviors occur in many clinical syndromes but are most commonly linked to obsessive compulsive disorder. Surprisingly little empirical work has examined the nature of hoarding behaviors despite their association with significant distress and impairment. The current study examined hoarding in 563 unselected college students. Using principal components analysis, we identified four domains of hoarding behaviors as measured by the 26-item Saving Inventory-Revised: Difficulty Discarding, Acquisition Problems, Clutter, and Interference/Distress. All four domains and total hoarding behaviors were strongly related to hoarding beliefs and to obsessive compulsive (OC) symptoms. Hoarding behaviors were most strongly correlated with subscales of an OC disorder (OCD) measure assessing hoarding and obsessions and least strongly correlated with the washing subscale. Hoarding behaviors also showed significant, but more modest, correlations with social anxiety, depressive symptoms, and worry. However, worry was not found to contribute unique variance to the prediction of hoarding behaviors. Of greatest note, hoarding behaviors showed a surprisingly strong relationship with anxiety sensitivity, similar in magnitude to the relationship between hoarding and OCD symptoms. Results are interpreted and lines of future research are proposed, with particular emphasis on further elucidating the relationship between hoarding behaviors and anxiety sensitivity.     

"Not just right experiences": perfectionism,obsessive-compulsive features and general psychopathology

Individuals with obsessive-compulsive disorder (OCD) frequently report uncomfortable sensations of things not being just right ("not just right experiences"; NJREs) and a need to ritualize until they quiet these sensations. However, very little work has been conducted to empirically examine the nature and characteristics of this phenomenon. In this paper, we present two studies that systematically examine NJREs in large undergraduate samples. In Study 1, NJREs were shown to be related to both OCD features and maladaptive domains of perfectionism. In Study 2, NJREs were again significantly related to OCD features. Further, NJREs were shown to have particularly strong relationships with specific OCD symptom clusters (e.g., checking, ordering). Finally, NJREs were significantly more strongly correlated with features of OCD than symptoms from other domains of psychopathology (e.g., social anxiety, trait anxiety, worry, depression). General conclusions are drawn, and future directions are discussed.     

Measurement of compulsive hoarding: saving inventory-revised

Four studies examined a new measure of compulsive hoarding (Saving Inventory-Revised; SI-R). Factor analysis using 139 hoarding participants identified 3 factors: difficulty discarding, excessive clutter, and excessive acquisition. Additional studies were conducted with hoarding participants, OCD participants without hoarding, community controls and an elderly sample exhibiting a range of hoarding behavior. Internal consistencies and test-retest reliabilities were good. The SI-R distinguished hoarding participants from all other non-hoarding comparison groups. The SI-R showed strong correlations with other indices and methods of measuring hoarding (beliefs, activity dysfunction from clutter, observer ratings of clutter in the home) and relatively weaker correlations with non-hoarding measures (positive and negative affect and OCD symptoms). The SI-R appears to be an appropriate instrument for assessing symptoms of compulsive hoarding in clinical and non-clinical samples.