Patients' Motivations and the Analyst's Experience

Although the analyst's way of organizing what he or she hears is influenced by assumptions about human motivation, the analyst's experience in the room with a patient is quite removed from any theories about motivation he or she might hold. So compelling is the clinical interaction that it may only be retrospectively that it is possible to observe how one's theory of motivation influences one's work. Several years ago, on the day before I began working on this paper, I took verbatim notes on the last three sessions of a holiday shortened week to see whether I could discern what assumptions about motivation I was making. I would not describe my theory of motivation as it appears at the end of the essay the way I did at the time I wrote this essay. Today, I would try to integrate drive theory with object relations more explicitly.     

Neurological subtle signs and cognitive development: A study in late childhood and adolescence

Introduction and Aim: Neurological subtle signs (NSS) are often observed during the neurological examination of children and tend to disappear with age. Their persistence into late adolescence or young adulthood has been related to psychiatric and neurocognitive disorders. To provide a better understanding of their functional basis, a longitudinal correlational study with neurocognitive measurements was performed.

Method: We conducted multiple regression and correlation analyses of NSS with demographic and cognitive measures on a subset of 341 healthy children (56% males), taking part in a longitudinal dental study. Participants, whose ages ranged between 11–15 years, at first evaluation, undertook yearly, during 5 years, a 6-item NSS exam (producing a total score ranging between 0–18) and a comprehensive battery of neurocognitive tests. Effects of age, gender, IQ, and 7 neurocognitive factors on NSS were analyzed.

Results: Over the years, NSS scores correlated consistently with selective attention (Stroop test), motor speed (finger tapping), and visuomotor speed (pegboard speed).

Discussion: These results suggest that the disappearance of NSS in late childhood and adolescence occurs primarily in parallel with the development of motor and visuomotor functions and secondarily in relation to higher order functions such as selective attention (Stroop) and executive control (B-A Trails difference).     

A Practice-Based Approach to Group Identification in Nonverbal Learning Disorders

Evidence-based practice, the rigorous conduct of clinical analysis and intervention, includes practice-based evidence. Here, practice data were the source of three “clinical portraits” used for exploratory analysis of an array of cognitive and social problems in 30 children whose neurobehavioral profiles fulfilled psychometric criteria for a nonverbal learning disability (NLD). Qualitative analysis of the children's academic and adjustment difficulties revealed patterns of dissociable deficits. These findings argue for at least three groups within the NLD construct. Identifying such subgroups is of practical importance: More precise characterization of neuropsychological competencies leads to improved interventions and better outcomes.     

General feelings of gratitude,gratitude to god,and hemoglobin A1c: Exploring variations by gender*

Research indicates that feeling grateful is associated with better physical health. However, most studies rely on self-reports of health. The purpose of this study is to see if feelings of gratitude in general as well as feeling grateful to God specifically are associated with a key biomarker of health – hemoglobin A1c (HbA1c). HbA1c is an indicator of blood sugar control. In the process of assessing the relationship between gratitude and HbA1c, an effort is made to see if the relationship between these measures and HbA1c vary by gender. Findings from a recent nationwide survey indicate that women are more likely than men to feel grateful in general and to feel grateful to God. The results further reveal stronger feelings of general gratitude are associated with lower levels of HbA1c. However, this relationship did not differ for men and women. In contrast, feeling grateful to God was associated with lower HbA1c, but this relationship emerged among women only.     

Modular cognitive-behavioral therapy for body dysmorphic disorder

This study pilot tested a newly developed modular cognitive–behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-month follow-ups. At posttreatment, BDD and related symptoms (e.g., mood) were significantly improved. Treatment gains were maintained at follow-up. A relatively low drop-out rate, high patient satisfaction ratings, and patient feedback indicated that the treatment was highly acceptable to patients. To our knowledge, this represents the first test of a broadly applicable, individual psychosocial treatment for BDD.     

Depression and quality of informal care: a longitudinal investigation of caregiving stressors

This research examined longitudinal associations between caregiving stressors, caregiver depression, and quality of care. Informal caregivers of elderly care recipients were interviewed at baseline (N = 310) and again one year later (N = 213). Hierarchical regression analyses indicated that increases in caregiving stressors (i.e., caregiver physical health symptoms, caregiver activity restriction, and care recipient controlling and manipulative behavior) were related to increased caregiver depression. In turn, increased caregiver depression and decreased caregiver respectful behavior predicted increases in potentially harmful behavior. These results extend previous cross-sectional findings and indicate that changes in caregiving stressors, caregiver depression, and caregiver respect over time may signal that intervention is warranted in order to forestall or prevent poor quality of care.     

Positive God Images and Positive Emotions toward God: Exploring Variations among Whites,Blacks, and Hispanics

How people view God is an important part of religious life. The purpose of this study is to see if four positive God image measures and two measures of positive emotions toward God vary among Whites, Blacks, and Hispanics. The data come from a recent nationwide survey in the United States (N = 2500). The findings reveal that, compared to Whites and Hispanics, Blacks have more positive image of God scores on all four measures. The data indicate that Blacks are also more likely than Whites and Hispanics to have strong positive emotions toward God. In contrast, consistent differences between Hispanics and Whites failed to emerge across all of the study measures.     

Delivery of internet treatment for compulsive hoarding (D.I.T.C.H.)

This study tested the effectiveness of an existing private online CBT-based group intervention designed to help people with hoarding. Web-group participants were hypothesized to show more improvement in hoarding symptoms over time compared to those placed on a naturalistic waitlist. This web-based self-help group (N = 106 members, N = 155 waitlisted) includes a formal application process and requires that participants post action steps and progress at least once monthly. Members have access to educational resources on hoarding, cognitive strategies, and a chat-group. Potential research participants were invited to complete an anonymous web-based survey about their hoarding behaviors and clinical improvement on five occasions (3 months apart). The sample was mainly middle-aged, female and White. Regression analyses show that Recent members reported greater improvement and less clutter at 6 months (than Waitlist). Long-term members reported milder hoarding symptoms than Recent ones, suggesting benefits from group participation over time. All members showed reductions in clutter and hoarding symptoms over 15 months. Less posting activity was associated with greater hoarding severity. Online CBT-based self-help for hoarding appears to be a promising intervention strategy that may extend access to treatment. Evaluating the benefits of internet self-help groups is critical given growing popularity of and demand for web-based interventions.     

Are there limits to collectivism? Culture and children's reasoning about lying to conceal a group transgression

This study explored the effects of collectivism on lying to conceal a group transgression. Seven‐, 9‐, and 11‐year‐old US and Chinese children (N=374) were asked to evaluate stories in which protagonists either lied or told the truth about their group's transgression and were then asked about either the protagonist's motivations or justification for their own evaluations. Previous research suggests that children in collectivist societies such as China find lying for one's group to be more acceptable than do children from individualistic societies such as the United States. The current study provides evidence that this is not always the case: Chinese children in this study viewed lies told to conceal a group's transgressions less favourably than did US children. An examination of children's reasoning about protagonists' motivations for lying indicated that children in both countries focused on an impact to self when discussing motivations for protagonists to lie for their group. Overall, results suggest that children living in collectivist societies do not always focus on the needs of the group. Copyright © 2010 John Wiley & Sons, Ltd.     

Anxiety enhances threat processing without competition among multiple inputs: a diffusion model analysis

Enhanced processing of threatening information is a well established phenomenon among high-anxious individuals. This effect is most reliably shown in situations where 2 or more items compete for processing resources, suggesting that input competition is a critical component of the effect. However, it could be that there are small effects in situations without input competition, but the dependent measures typically used are not sensitive enough to detect them. The present study analyzed data from a noncompetition task, single-string lexical decision, with the diffusion model, a decision process model that provides a more direct measure of performance differences than either response times or accuracy alone. The diffusion model analysis showed a consistent processing advantage for threatening words in high-anxious individuals, whereas traditional comparisons showed no significant differences. These results challenge the view that input competition is necessary for enhanced threat processing. Implications for theories of anxiety are discussed.