An open clinical trial of cognitive-behaviour therapy in children and adolescents with obsessive-compulsive disorder administered in regular outpatient clinics

The aim of the present study was to examine the effectiveness of manual-guided cognitive-behaviour therapy (CBT) for childhood obsessive-compulsive disorder (OCD) administered within three regular, i.e., non-academic, Norwegian outpatient child psychiatric clinics. METHODS: A total of 28 youngsters, aged 8-17 with primary OCD entered the study. Assessment at intake included Norwegian versions of the K-SADS-PL, Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), and a measure of OCD-specific functional impairment (Child OCD Impact Scale (COIS)). Therapy consisted of 12 manual-guided sessions with combined individual and family CBT-based interventions and was conducted by psychologists and physicians under training and supervision. Outcome was assessed after treatment and at 3- and 6-month follow-ups by means of the CY-BOCS, the Clinical Global Impression (CGI) and the CGI-Improvement scales, and the COIS. RESULTS: Twenty-four youngsters (86%) completed treatment and were available for the follow-up assessments. Significant improvements were found on all outcome measures after treatment, including a mean symptom reduction on the CY-BOCS of 60.6%, increasing to 68.8% at the 6-month follow-up. Estimates of within-group effect sizes showed strong effects of treatment. CONCLUSION: The results of the present study suggest that manual-guided CBT for childhood OCD can be successfully implemented in non-academic community child psychiatric settings with outcomes in accordance with previous findings from highly specialised university clinics.     

What is the self? A psychobiological perspective

Philosophers have long struggled with questions about the nature of personal identity and of the self, with some viewing the self as a transcendent entity, and others arguing that the self is a constructed fiction. An approach based in cognitive-affective neuroscience emphasizes that self-related structures and processes are based in the brain-mind, and emerge within the social processes of human development. Alterations in such structures and processes are present in a wide range of neurological and psychiatric disorders, and neuropsychiatric lesion and functional brain imaging studies have led to more detailed awareness of the precise neuronal circuitry underlying self-representations. A cognitive-affective neuroscience approach provides a conceptual basis from which clinical research can further explore how best to assess and treat a wide range of disruptions to the self.     

Coping with challenge and hindrance stressors in teams: Behavioral,cognitive, and affective outcomes

The purpose of this study was to utilize the challenge–hindrance framework to examine the discrete and combined effects of different environmental stressors on behavioral, cognitive, and affective outcomes at the team level. Results from 83 teams working on a command and control simulation indicated that the introduction of a challenge stressor positively affected team performance and transactive memory. The introduction of a hindrance stressor negatively affected team performance and transactive memory and positively affected psychological withdrawal. When the hindrance stressor was combined with the challenge stressor, teams exhibited the lowest levels of performance and transactive memory, and the highest levels of psychological withdrawal. These effects were due to the adoption of specific coping strategies by team members. Implications are discussed, as well as limitations and directions for future research.     

Internet addiction among Norwegian adults: a stratified probability sample study

Most Norwegians are Internet users. We conducted a stratified probability sample study (Norway, 2007, age-group 16–74 years, N = 3,399, response rate 35.3%, 87.1% Internet users) to assess the prevalence of Internet addiction and at-risk Internet use by the Young Diagnostic Questionnaire (YDQ). The prevalence of Internet addiction (YDQ score 5–8) was 1.0% and an additional 5.2% were at-risk Internet users (YDQ score 3–4). Internet addiction and at-risk Internet use was strongly dependent on gender and age with highest prevalences among young males (16–29 years 4.1% and 19.0%, 30–39 years 3.3% and 10.7%). Logistic regression showed that male gender, young age, university level education, and an unsatisfactory financial situation were factors positively associated with "problematic Internet use" (at-risk and addicted use combined). Time spent on the Internet and prevalence of self-reported sleeping disorders, depression, and other psychological impairments increased linearly with YDQ score. Problematic Internet use clearly affects the lives of many people.     

CRITICISM OF LITERATURE AND CRITICISM OF CULTURE

There is a class of critics who are dissatisfied with the academic status of literary criticism and who want to re-establish for literary criticism the status it possessed in the early and mid nineteenth century as simultaneously cultural and social criticism. This is an impossible task. The 'cultural critics' of the nineteenth century possessed their authority because they were without competition and because they could command the attention and respect of the whole of the literate audience. However, at the end of the nineteenth century intellectual authority came to be based in specialised academic disciplines and individual authority was undermined and ultimately disappeared. At the same time, the arrival of universal literacy in Britain fragmented and ultimately destroyed the generally educated audience to which the cultural critics addressed themselves. Consequently there is today no role for the cultural critic. Literary critics cannot speak with authority about social, political, or cultural questions. They can, however, speak with authority about literature. Whether or not this criticism can be grounded in disciplinary knowledge, it serves a necessary function for an audience that no longer possesses the skill of reading literary works and lacks the background knowledge that is necessary to make sense of literature.     

The Experiences of Guilt and Shame: A Phenomenological–Psychological Study

This study aims at discovering the essential constituents involved in the experiences of guilt and shame. Guilt concerns a subject’s action or omission of action and has a clear temporal unfolding entailing a moment in which the subject lives in a care-free way. Afterwards, this moment undergoes a reconstruction, in the moment of guilt, which constitutes the moment of negligence. The reconstruction is a comprehensive transformation of one’s attitude with respect to one’s ego; one’s action; the object of guilt and the temporal-existential experience. The main constituents concerning shame are its anchorage in the situation to which it refers; its public side involving the experience of being perceptually objectified; the exclusion of social community; the bodily experience; the revelation of an undesired self; and the genesis of shame in terms of a history of frozen now-ness. The article ends with a comparison between guilt and shame.     

Video interaction guidance inviting transcendence of postpartum depressed mothers' self‐centered state and holding behavior

By sometimes evoking self‐absorbed and avoidance behaviors in new mothers, postnatal depression affects the quality of mother–infant interaction, which in turn may invoke distress and avoidance in the infant and cause even more lasting impairment in the child's development. Three depressed mothers, A, B, and C, are reported upon after having been offered counseling in accordance with the Marte Meo approach through jointly watching with the therapist video replays of themselves interacting with their newborns. Clinical vignettes are offered which indicate how empathic and positive support of a sensitive therapist can be helpful in inviting the mother's recognition of her importance to her infant and facilitating mutually gratifying interaction between mother and child. Protocol analyses of select sessions of video‐related therapy reveal that two of the mothers sometimes complete the therapist's unfinished statements in an other‐centered manner, thereby transcending their initial self‐centered state. This is most dramatic in the case of Mother A, who starts out in the first session almost incapable of speech, merely nodding or shaking her head. In addition to other indications of improved mother–infant interaction, comparison of pre‐ and postguidance windows regarding the three mothers' holding behaviors reveals a shift from an avoidance or anxious stance to closer and more secure holding.     

The utility of the AusEd driving simulator in the clinical assessment of driver fatigue

Several driving simulators have been developed which range in complexity from PC based driving tasks to advanced "real world" simulators. The AusEd driving simulator is a PC based task, which was designed to be conducive to and test for driver fatigue. This paper describes the AusEd driving simulator in detail, including the technical requirements, hardware, screen and file outputs, and analysis software. Some aspects of the test are standardized, while others can be modified to suit the experimental situation. The AusEd driving simulator is sensitive to performance decrement from driver fatigue in the laboratory setting, potentially making it useful as a laboratory or office based test for driver fatigue risk management. However, more research is still needed to correlate laboratory based simulator performance with real world driving performance and outcomes.     

Use of the MMPI-A to detect substance abuse in a juvenile correctional setting.

In this study, we examined the ability of the MMPI-A (Butcher et al., 1992) to detect substance abuse problems in a juvenile correctional setting. Specifically, we evaluated the Alcohol/Drug Problem Acknowledgment scale (ACK; Weed, Butcher, & Williams, 1994), the Alcohol/Drug Problem Proneness scale (PRO; Weed et al., 1994), and the MacAndrew Alcoholism Scale-Revised (MAC-R; Butcher et al., 1992) in the prediction of substance abuse. In addition, the incremental validity of ACK in comparison to PRO was evaluated, as was the incremental validity of PRO in comparison to ACK. The sample consisted of 123 boys and girls from ajuvenile correctional facility in Northeastern Ohio. Results indicate that ACK and PRO, but not MAC-R, were related to interviewer ratings of substance abuse. Results point to the superiority of ACK over PRO in substance abuse identification.