Initiation of evidence-based psychotherapies in Veterans with posttraumatic stress disorder

The Department of Veterans Affairs (VA) requires that all VA hospitals and clinics provide access to evidence-based psychotherapies (EBPs). Despite these widespread dissemination efforts, only a minority of Veterans receive EBP services. Reasons for these low rates of EBP utilization are largely unknown. This study examined the characteristics of Veterans with posttraumatic stress disorder (PTSD) who did (Initiation group) and did not (No-Initiation group) initiate a VA-approved EBP after participating in an information session. Veterans chose their preferred treatment from a menu of EBPs. Results demonstrated that Veterans in the No-Initiation group had longer periods of time between their referral and first EBP visit. Among Veterans in the Initiation group, the majority (68%) initiated a trauma-focused EBP as their first or second treatment, suggesting that providing a range of treatment options did not negatively impact their willingness to engage in PTSD treatment. Results are discussed in terms of VA initiatives to improve access to and initiation of mental health care for Veterans.     

The interaction of pathways to fear in childhood anxiety: a preliminary study

Recent research has shown that the verbal information pathway to fear creates long-term fear cognitions and can create cognitive biases and avoidance in children. However, the interaction between the verbal information pathway to fear and other pathways is untested. This experiment exposed children (aged 6–8) to threat information about a novel animal to see the impact on a measure of avoidance after a subsequent simulated direct negative encounter with that animal. Results showed that a direct negative experience (without prior information) or threat information (without a subsequent negative experience) produced similar effects, but in combination (verbal threat information followed by a direct negative experience) the effect was significantly magnified. These results support theories of fear acquisition that suppose that verbal information impacts on the strength of associations formed in subsequent conditioning episodes, and suggest that pathways to fear have interactive effects.     

Workplace emotions: the role of supervision and leadership

In this experience sampling study, the authors examined the role of organizational leaders in employees' emotional experiences. Data were collected from health care workers 4 times a day for 2 weeks. Results indicate supervisors were associated with employee emotions in 3 ways: (a) Employees experienced fewer positive emotions when interacting with their supervisors as compared with interactions with coworkers and customers; (b) employees with supervisors high on transformational leadership experienced more positive emotions throughout the workday, including interactions with coworkers and customers; and (c) employees who regulated their emotions experienced decreased job satisfaction and increased stress, but those with supervisors high on transformational leadership were less likely to experience decreased job satisfaction. The results also suggest that the effects of emotional regulation on stress are long lasting (up to 2 hr) and not easily reduced by leadership behaviors.     

Models of misbelief: Integrating motivational and deficit theories of delusions

The impact of our desires and preferences upon our ordinary, everyday beliefs is well-documented [Gilovich, T. (1991). How we know what isn’t so: The fallibility of human reason in everyday life. New York: The Free Press.]. The influence of such motivational factors on delusions, which are instances of pathological misbelief, has tended however to be neglected by certain prevailing models of delusion formation and maintenance. This paper explores a distinction between two general classes of theoretical explanation for delusions; the motivational and the deficit. Motivational approaches view delusions as extreme instances of self-deception; as defensive attempts to relieve pain and distress. Deficit approaches, in contrast, view delusions as the consequence of defects in the normal functioning of belief mechanisms, underpinned by neuroanatomical or neurophysiological abnormalities. It is argued that although there are good reasons to be sceptical of motivational theories (particularly in their more floridly psychodynamic manifestations), recent experiments confirm that motives are important causal forces where delusions are concerned. It is therefore concluded that the most comprehensive account of delusions will involve a theoretical unification of both motivational and deficit approaches.     

Knowledge about a common source can promote visual- haptic integration

The brain integrates object information from multiple sensory systems to form a unique representation of our environment. Temporal synchrony and spatial coincidence are important factors for multisensory integration, indicating that the multisensory signals come from a common source. Spatial separations can lead to a decline of visual-haptic integration (Gepshtein et al, 2005 Journal of Vision 5 1013-1023). Here we tested whether prior knowledge that two signals arise from the same object can promote integration even when the signals are spatially discrepant. In one condition, participants had direct view of the object they touched. In a second condition, mirrors were used to create a spatial separation between the seen and the felt object. Participants saw the mirror and their hand in the mirror exploring the object and thus knew that they were seeing and touching the same object. To determine the visual-haptic interaction we created a conflict between the seen and the felt shape using an optically distorting lens that made a rectangle look like a square. Participants judged the shape of the probe by selecting a comparison object matching in shape. We found a mutual biasing effect of shape information from vision and touch, independent of whether participants directly looked at the object they touched or whether the seen and the felt object information was spatially separated with the aid of a mirror. This finding suggests that prior knowledge about object identity can promote integration, even when information from vision and touch is provided at spatially discrepant locations.     

Behavioral avoidance tests and disgust in contamination fears: distinctions from trait anxiety

Much of the existing literature examining the role of disgust is limited to specific phobia. Recent research has begun to examine the role of disgust in contamination fear, a subtype of obsessive-compulsive symptoms. Through the use of behavioral avoidance tasks (BATs), the current study was designed to examine the role of disgust in people with contamination fears, with attention to distinguishing high and low trait anxiety. From a large screening of undergraduate students, three groups were formed based on their level of contamination fear and level of trait anxiety: contamination fearful ( n = 12 ), high-trait anxiety ( n = 11 ), and low trait anxiety ( n = 15 ). Subjects were asked to engage in six different BATs corresponding to six domains of disgust (food, animals, body products, body envelope violations, death, and sympathetic magic). One-way analysis of variance (ANOVA) showed significant differences between the contamination fearful group and the high trait anxiety group on the animal and sympathetic magic BATs. Significant differences on the food, animal, body envelope violations, and death BATs were also found between the contamination fearful group and the low-trait anxious group. The findings modestly support the importance of disgust in contamination fears. Implications for the study of disgust in contamination fear are provided.     

Family-level impact of the CHAMP Family Program: a community collaborative effort to support urban families and reduce youth HIV risk exposure

This article presents family-level results from an ongoing study examining the impact of the CHAMP (Chicago HIV prevention and Adolescent Mental health Project) Family Program, a family-based HIV preventative intervention meant to reduce the amount of time spent in situations of sexual possibility and delay initiation of sexual activity for urban youth in the 4th and 5th grades living in neighborhoods with high rates of HIV infection. The CHAMP Family Program has been developed, delivered, and overseen by a collaborative partnership, consisting of community parents, school staff, community-based agency representatives, and university-based researchers. Design of the program was informed by input from this collaborative partnership, child developmental theory of sexual risk, and empirical data gathered from the targeted community. This article presents findings that suggest CHAMP Family Program impact on family communication, family decision-making, and family-level influences hypothesized to be related to later adolescent HIV risk. Implications for future family-based HIV prevention research are discussed here.     

Memory for thematically arousing events

Many studies have indicated that emotional arousal improves memory for the center, or gist, of an event but undermines memory for the event's periphery. However, all of these studies have elicited emotion by showing participants some salient visual stimulus intended to arouse them (e.g., the sight of a wound). This stimulus may have served as an attention magnet, and this, not the arousal, may have been the cause of the observed narrowing of memory. In this article, we examine how participants remember events that involve thematically induced arousal, arousal produced by empathy, rather than by a visual emotional stimulus. The data show that emotionality improves memory for all aspects of these events, with no memory narrowing.     

What's in a name for memory errors? Implications and ethical issues arising from the use of the term "false memory" for errors in memory for details

The term "false memories" has been used to refer to suggestibility experiments in which whole events are apparently confabulated and in media accounts of contested memories of childhood abuse. Since 1992 psychologists have increasingly used the term "false memory" when discussing memory errors for details, such as specific words within lists. Use of the term to refer to errors in details is a shift in language away from other terms used historically (e.g., "memory intrusions"). We empirically examine this shift in language and discuss implications of the new use of the term "false memories." Use of the term presents serious ethical challenges to the data-interpretation process by encouraging over-generalization and misapplication of research findings on word memory to social issues.     

The structure of childhood obsessions and compulsions: dimensions in an outpatient sample

While obsessive-compulsive disorder (OCD) is defined as a unitary condition, prior research has identified meaningful and distinct symptom dimensions in adult samples. In contrast, there have been no investigations of symptom dimensions in samples of children diagnosed with OCD. The present study sought to address this gap. Children diagnosed with OCD (n = 137) were administered the Children's Yale-Brown Obsessive-Compulsive Scale symptom checklist and severity index. Symptoms were analyzed using principal components analysis. As with adult samples, four factors were identified from the checklist. However, these four factors (compulsions, sexual/aggressive obsessions, superstitions, and hoarding/ordering/somatic concerns) were different in content from adult studies. Further, several symptoms significantly contributed to more than one dimension. Each dimension was significantly correlated with scores from the severity index, with the exception of the obsession score with the hoarding/ordering/somatic concerns factor. Results suggest that there are distinct dimensions of symptoms in childhood OCD, but that these dimensions do not correspond to those identified in adults. Instead, it appears that some factors share variance, and the dimensions themselves are separated based upon developmental trajectories. The dimensions examined may be useful in future treatment studies using pharmacological and/or behavioral interventions.