A Propensity Score Analysis of Homework Adherence-Outcome Relations in Cognitive Behavioral Therapy for Depression

Little is known about whether or not a consistently high level of homework adherence over the course of therapy benefits patients. This question was examined in two samples of patients who were receiving individual Cognitive Behavioral Therapy (CBT) for depression (Ns = 128 [Sequenced Treatment Alternatives to Relieve Depression: STAR-D] and 183 [Continuation Phase Cognitive Therapy Relapse Prevention: C-CT-RP]). Logistic and linear regression and propensity score models were used to identify whether or not clinician assessments of homework adherence differentiated symptom reduction and remission, as assessed by the Hamilton Depression Rating Scale-17 (HDRS-17), the Quick Inventory of Depressive Symptomatology–Self-Reported Scale (QIDS-SR), and the QIDS–Clinician Scale (QIDS-C). CBT-related response and remission were equally likely between both high and low homework adherers in both studies and in all models. But in propensity adjusted models that adjusted for session attendance, for both the STAR-D and C-CT-RP samples, greater homework adherence was significantly associated with greater response and remission from depression in the first and last 8 sessions of CBT. Our results suggest that homework adherence can account for response and remission early and late in treatment, with adequate session attendence.     

Negation on the Australian Plan

Journal of Philosophical Logic - We present and defend the Australian Plan semantics for negation. This is a comprehensive account, suitable for a variety of different logics. It is based on two...     

The Political Activity of Evangelical Clergy in the Election of 2000: A Case Study of Five Denominations

This article focuses on the political participation of ministers from five evangelical Protestant denominations that differ in theology, polity, and history. Despite such differences, these clergy respond to political influences in much the same fashion. We find that the standard theories of political participation have varying success in accounting for their political involvement. Sociodemographic explanations provide little help, but psychological engagement with politics has more explanatory power. Professional role orientations are the best predictors of actual participation. And the clergy who see moral reform issues as the most important confronting the country—and who hold conservative views on such issues—are most likely to become engaged. Finally, membership in Christian Right organizations serves to elicit more activity than might occur if ministers were left to internally motivated participation. Despite the emphasis on other contextual variables in some work on clerical politics, we find that communications exposures, congregational influences, and even the support of clerical colleagues have very limited independent effects on political involvement.     

Outcomes of Parent Education Programs Based on Reevaluation Counseling

We report two studies in which a parent education program based on Reevaluation Counseling was field-tested on mothers randomly assigned to treatment groups or equivalent, no-treatment comparison groups. The goal was to evaluate the program's viability, whether there were measurable effects, whether those effects were sustained over time, and whether the program was effective among diverse populations. The first study involved middle income, married mothers (n = 25) with at least one child younger than age five. Eleven members of the no-treatment group participated in the program three months later. Pretest, posttest, and follow-up measures included a parental attitude survey and a parenting stress index. The second study involved 18 black mothers with children enrolled in Head Start. Six members of the no-treatment group participated in the program two months later. Added to the pretest, posttest, and follow-up measures were a parent attitude research instrument and a parenting practices questionnaire. Results were replicated within and across studies. Significant effects suggest that the program can reduce parenting-related stress, improve parental attitudes, and encourage authoritative parenting practices, although some effects tend to diminish somewhat over time. The program appears viable with mothers of various social status groups.     

Regularity effects in word naming: What are they?

In a word-naming experiment, word-body consistency was crossed with grapheme-to-phoneme regularity to test predictions of current models of word recognition. In the latency and error data, a clear effect of consistency was observed, with the influence of regularity somewhat weaker. In addition, simulation data from three contemporary models of word recognition were obtained for the stimuli used in the experiment in order to compare the models' latencies with those of humans. The simulations showed that the human latency data are most consistent with the parallel-distributed-processing model of Plaut, McClelland, Seidenberg, and Patterson (1996), less so with the dual-process model (Zorzi, Houghton, & Butterworth, 1998), and least so with the dual-route-cascaded model (Coltheart & Rastle, 1994).     

The impact of an unpredictable context and intolerance of uncertainty on the electrocortical response to monetary gains and losses

There is growing evidence that unpredictability and uncertainty can alter reward system functioning. The present study examined the impact of (1) a task-irrelevant unpredictable relative to predictable context and (2) individual differences in intolerance of uncertainty (IU) on the reward-related positivity (RewP), an event-related potential (ERP) response to monetary gains relative to losses. Specifically, 64 participants listened to predictable and unpredictable tone sequences while electroencephalography was recorded during a monetary gambling task. Participants also completed the Intolerance of Uncertainty Scale, which measures both cognitive distress (prospective IU) and behavioral inhibition (inhibitory IU) elicited by uncertainty, in addition to the Depression Anxiety Stress Scale-21 and Penn State Worry Questionnaire. Results indicated that the RewP was reduced during the unpredictable relative to the predictable context. Greater self-reported anxiety elicited by the unpredictable context was associated with a decreased RewP, and a decreased RewP was associated with poorer lose-shift behavioral adjustment. Furthermore, the RewP mediated the relationship between self-reported anxiety elicited by the unpredictable context and lose-shift behavioral adjustment. The IU subscales demonstrated the opposite relationship with the RewP across both contexts—inhibitory IU was associated with an attenuated RewP and prospective IU was associated with an enhanced RewP. In contrast, anxiety, depression, stress, and worry symptomatology were not associated with the RewP. This is the first study to demonstrate that an unpredictable context and individual differences in the degree to which people cannot tolerate uncertainty impact an ERP measure of reward system functioning.     

A third language in therapy: deconstructing sameness and difference

The paper draws on recent research and the first author’s personal story to show what happens when the language difference between therapist and client is brought to mutual awareness in the therapy room. Individual lived experiences of migrant psychotherapists and counsellors and the issues that arise in therapy practice when the practitioners use their second language as the means of communication with clients are explored. The notion of a third language – a dynamic communication system that is a result of developing a professional identity through a second language – is introduced. Unlike the psychoanalytic third, it is often conscious and may be used either defensively or purposefully as a concrete third point of reference in the intersubjective encounter. The paper explores how the concept of a ‘Third Language’ can be used as a tool to negotiate perceived sameness or difference in therapeutic encounters and to build a common language with a client, both literally and metaphorically. The study featured in the paper has implications for practice, theory and research.