Medication-assisted treatment research with criminal justice populations: challenges of implementation

Creating, implementing and evaluating substance abuse interventions, especially medication-assisted treatments, for prisoners, parolees, and probationers with histories of heroin addiction is an especially challenging endeavor because of the difficulty in coordinating and achieving cooperation among diverse criminal justice, substance abuse treatment, research, and social service agencies, each with its own priorities and agenda. In addition, there are special rules that must be followed when conducting research with criminal justice-involved populations, particularly prisoners. The following case studies will explore the authors' experience of over 10 years conducting pharmacotherapy research using methadone, buprenorphine, and naltrexone with criminal justice populations. The major obstacles and how they were overcome are presented. Finally, recommendations are provided with regard to implementing and conducting research with criminal justice populations. Copyright © 2011 John Wiley & Sons, Ltd.     

Perfectionism,Type A Behavior,and Self-Efficacy in Depression and Health Symptoms among Adolescents

The current study examined the associations among dimensions of perfectionism, Type A behavior, self-efficacy, distress, and health symptoms in high school students. A sample of 73 high school students (34 boys, 39 girls) completed measures of self-oriented perfectionism, socially prescribed perfectionism, Type A behavior, self-efficacy, depressive symptoms, and psychosomatic symptoms. Correlational analyses found that self-oriented perfectionism was marginally related to Type A behavior. Students with elevated levels of depressive symptoms were also characterized by self-oriented perfectionism, Type A behavior, low self-efficacy, and health symptoms. In addition, health symptoms were linked with low self-efficacy. Simultaneous entry of several variables into a regression analysis found that significant unique predictors of depression were low self-efficacy and elevated self-oriented perfectionism. Similarly, a regression analysis found that low self-efficacy and high self-oriented perfectionism were unique predictors of health symptoms. The findings highlight the distinctions between the perfectionism and the Type A constructs, and support self-regulation models of depression and physical symptoms that include an emphasis on excessive perfectionistic standards and low self-efficacy. We discuss the need for preventive interventions designed for perfectionistic adolescents with low self-efficacy.     

Perfectionistic self-presentation in children and adolescents: development and validation of the Perfectionistic Self-Presentation Scale--Junior Form

Research on adults indicates that perfectionistic self-presentation, the interpersonal expression of one's perfection, is associated with a variety of psychopathological outcomes independent of trait perfectionism and Big Five traits. The current article reports on the development and evidence for the validity of the subtest score interpretations of an 18-item self-report measure of perfectionistic self-presentation for children and adolescents. Analyses conducted on data from two clinical samples and one nonclinical sample of children and adolescents found that the Perfectionistic Self-Presentation Scale--Junior Form (PSPS-Jr) reflected a multidimensional model of perfectionistic self-presentation with three subscales: Perfectionistic Self Promotion, Nondisplay of Imperfection, and Nondisclosure of Imperfection. The subscale scores were found to demonstrate internal consistency, and there was good evidence supporting the validity of the interpretation of subscale scores based on this new measure. The subscales were associated with maladaptive outcomes, but were not influenced unduly by biases that included social desirability and differential item functioning by gender. Overall, the PSPS-Jr appears to be a useful measure of the expression of perfection among youths and an important tool in attempting to understand the nature and the consequences of perfectionistic self-presentation in children and adolescents.     

SOCIAL‐LEARNING PROGRAMS FACILITATE AN INCREASE IN ADAPTIVE BEHAVIOR IN A FORENSIC MENTAL HOSPITAL

Deficits in adaptive behavior are a major reason why individuals remain hospitalized or return to inpatient settings. During recovery from a serious mental illness, development of adaptive behavior is as important as reduction of ‘symptoms’. Social learning programs (SLPs) have been identified as a best practice in inpatient settings. This study examined whether SLPs facilitated significant growth in adaptive behavior from baseline through one, two, three, and four years of intervention. Direct observational coding of adaptive behavior was conducted before and during intervention and subjected to pre‐post analysis. In addition, individual change modeling was used to characterize the rate and extent of change. Finally, initial response to intervention was examined for utility in predicting total response at distal time points. The SLPs facilitated significant improvements in total adaptive behavior from baseline to each of the distal time points (with effect sizes from 1.18 to 1.53). Change during the first five weeks failed to consistently predict total change, likely because of adaptive intervention procedures. SLPs facilitated significant improvements in the kind of adaptive behavior that helps people get out and stay out of inpatient settings. If replicated, estimated rates of change established in this study could be used as benchmarks for future implementations. Copyright © 2011 John Wiley & Sons, Ltd.     

Thanks, but I'm used to better: a relative rank model of gratitude

We argue that more help does not necessarily lead to more gratitude. Rather, gratitude depends on how a given instance of help compares with the help that a person is used to receiving. Participants read vignettes detailing an event in which 11 different friends either lent them varying amounts of money or spent varying amounts of time providing help. The amount of gratitude elicited by a given amount of help (e.g., a loan of ￡36 [about $56] or 49 min help) differed substantially depending on how this amount ranked among the help they were getting from their other friends. Comparison across four experimental conditions suggested that these judgments operated via the same general cognitive mechanisms used to judge other social events and psychophysical stimuli (as outlined by range frequency theory). Although more help does lead to more gratitude, people appear to be sensitive to how that help compares with what others are providing, and experienced gratitude depends on these relative judgments.     

A feasibility study of Acceptance and Commitment Therapy for emotional dysfunction following psychosis

The experience of psychosis can lead to depression, anxiety and fear. Acceptance and Commitment Therapy (ACT) facilitates individuals to accept difficult mental experiences and behave in ways that are consistent with personally held values. This study was a single (rater) blind pilot randomised controlled trial of ACT for emotional dysfunction following psychosis. Twenty-seven participants with psychosis were randomised to either: ten sessions of ACT plus treatment as usual (TAU) or TAU alone. The Hospital Anxiety and Depression Scale, Positive and Negative Syndrome Scale, Acceptance and Action Questionnaire, Kentucky Inventory of Mindfulness Skills and Working Alliance Inventory were used. Individuals were assessed at baseline and 3 months post-baseline. The individuals randomised to receive ACT found the intervention acceptable. A significantly greater proportion of the ACT group changed from being depressed at time of entry into the study to not being depressed at follow-up. The ACT group showed a significantly greater increase in mindfulness skills and reduction in negative symptoms. Results indicated that individuals randomised to ACT had significantly fewer crisis contacts over the study. Changes in mindfulness skills correlated positively with changes in depression. ACT appears to offer promise in reducing negative symptoms, depression and crisis contacts in psychosis.     

Bimanual reaching across the hemispace: Which hand is yoked to which?

When both hands perform concurrent goal-directed reaches, they become yoked to one another. To investigate the direction of this coupling (i.e., which hand is yoked to which), the temporal dynamics of bimanual reaches were compared with equivalent-amplitude unimanual reaches. These reaches were to target pairs located on either the left or right sides of space; meaning that in the bimanual condition, one hand's contralateral (more difficult) reach accompanied by the other hand's ipsilateral (easier) reach. By comparing which hand's difficult reach was improved more by the presence of the other hand's easier ipsilateral reach, we were able to demonstrate asymmetries in the coupling. When the cost of bimanual reaching was controlled for the contralateral reaching left hand's performance was improved, suggesting that the left hand is yoked to the right during motor output. In contrast, the right hand showed the greatest improvements for contralateral reaching in terms of reaction time, pointing toward a dominant role for the left hand in the processes prior to movement onset. The results may point toward a mechanism for integrating the unitary system of attention with bimanual coordination.     

When giving feels good. The intrinsic benefits of sacrifice in romantic relationships for the communally motivated

Who benefits most from making sacrifices for others? The current study provides one answer to this question by demonstrating the intrinsic benefits of sacrifice for people who are highly motivated to respond to a specific romantic partner's needs noncontingently, a phenomenon termed communal strength. In a 14-day daily-experience study of 69 romantic couples, communal strength was positively associated with positive emotions during the sacrifice itself, with feeling appreciated by the partner for the sacrifice, and with feelings of relationship satisfaction on the day of the sacrifice. Furthermore, feelings of authenticity for the sacrifice mediated these associations. Several alternative hypotheses were ruled out: The effects were not due to individuals higher in communal strength making qualitatively different kinds of sacrifices, being more positive in general, or being involved in happier relationships. Implications for research and theory on communal relationships and positive emotions are discussed.     

Episodic Representation of Diagnostic and Non-Diagnostic Object Color

In three experiments, we investigated transsaccadic object file representations. In each experiment, participants moved their eyes from a central fixation cross to a saccade target located between two peripheral objects. During the saccade, this preview display was replaced with a target display containing a single object to be named. On trials in which the target identity matched one of the preview objects, its color either matched or did not match the previewed object color. The results indicated that color changes disrupt perceptual continuity, but only for the class of objects for which color is diagnostic of object identity. When the color is not integral to identifying an object (for example, when the object is a letter or an object without a characteristic color), object continuity is preserved regardless of changes to the object's color. These results suggest that object features that are important for defining the object are incorporated into its episodic representation. Furthermore, the results are consistent with previous work showing that the quality of a feature's representation determines its importance in preserving continuity.