Clinician competencies: Strengths and limitations for work with transgender and gender non-conforming (TGNC) clients

Individuals who identify as transgender or gender nonconforming (TGNC) face a number of health disparities compared to individuals who identify as cisgender (those who self-identify with the sex they were assigned at birth). For example, TGNC individuals experience heightened rates of clinical depression, anxiety, general psychological distress, suicidal ideation, and suicide attempts. Despite these troubling disparities, many TGNC individuals report hesitance to seek mental health services due to concerns regarding culturally insensitive or even overtly discriminatory services from providers. In addition to decreasing service utilization among TGNC populations, discriminatory services impair intervention effectiveness even when TGNC individuals persist in seeking mental health services. The American Psychological Association (APA) and the World Professional Association for Transgender Health (WPATH) provide guidelines for culturally competent work with TGNC clients; however, research indicates a profound lack of TGNC-specific training and resources among mental health care providers. To address this gap, the present investigation utilized a mixed-method design to assess training experiences, understanding of terminology, and TGNC competence among mental health care providers at various training levels. Participants were current mental health clinicians across the United States. Implications for improving reported and demonstrated weaknesses are discussed.     

Eye tracking reveals the cost of switching between self and other perspectives in a visual perspective-taking task

Previous studies have shown that while people can rapidly and accurately compute their own and other people’s visual perspectives, they experience difficulty ignoring the irrelevant perspective when the two perspectives differ. We used the “avatar” perspective-taking task to examine the mechanisms that underlie these egocentric (i.e., interference from their own perspective) and altercentric (i.e., interference from the other person’s perspective) tendencies. Participants were eye-tracked as they verified the number of discs in a visual scene according to either their own or an on-screen avatar’s perspective. Crucially in some trials the two perspectives were inconsistent (i.e., each saw a different number of discs), while in others they were consistent. To examine the effect of perspective switching, performance was compared for trials that were preceded with the same versus a different perspective cue. We found that altercentric interference can be reduced or eliminated when participants stick with their own perspective across consecutive trials. Our eye-tracking analyses revealed distinct fixation patterns for self and other perspective taking, suggesting that consistency effects in this paradigm are driven by implicit mentalizing of what others can see, and not automatic directional cues from the avatar.     

Athletes as heroes and role models: an ancient model

A common argument for the social value of sport is that athletes serve as heroes who inspire people – especially young people – to strive for excellence. This argument has been questioned by sport philosophers at a variety of levels. Not only do athletes seem unsuited to be heroes or role models in the conventional sense, it is unclear more generally what the social and educational value of athletic excellence could be. In this essay, I construct an argument for the social and educational value of sport built upon the relationship between athletes, heroes, and the song culture that celebrated them in ancient Greece. On this model, athletes are neither heroes nor role models in the conventional sense. Rather, athletes, athletics, and the poets who extolled them were part of a cultural conspiracy to celebrate and inspire virtue (aretē) by connecting a community with its heroic past. Festivals such as the Olympic Games, but also local events such as funeral games, educated and unified communities by cultivating an aesthetic appreciation for virtue and by inspiring youth to strive for it. Ancient athletes were not heroes, rather they re-enacted heroic struggles, thereby experiencing heroic virtues, and inspiring both artists and spectators to bond with the higher ideals implied by their shared belief in divine ancestry. In this way, athletes, athletics, and the media that celebrated them played important social and educational roles. Insofar as modern sport performs a similar service, its association with heroism and with moral education may ultimately be justified.     

Time–space synaesthesia – A cognitive advantage?

Is synaesthesia cognitively useful? Individuals with time–space synaesthesia experience time units (such as months of the year) as idiosyncratic spatial forms, and report that these forms aid them in mentally organising their time. In the present study, we hypothesised that time–space synaesthesia would facilitate performance on a time-related cognitive task. Synaesthetes were not specifically recruited for participation; instead, likelihood of time–space synaesthesia was assessed on a continuous scale based on participants’ responses during a semi-structured interview. Participants performed a month-manipulation task, which involved naming every second month or every third month in reverse-chronological order, beginning and ending with a target month. Using hierarchical multiple regression, we found that time–space synaesthesia corresponded with faster performance on both versions of the task. We propose that time–space synaesthesia may expedite the cognitive manipulation of time-based information. Our results also indicate that synaesthesia is far less unusual than widely believed.     

Perceptions of Type 1 Diabetes among Affected Youth and their Peers

Management of type 1 diabetes (T1D) involves balancing several components including diet, exercise, and medication. Peer involvement in management tasks is an important, but understudied, issue in T1D. This study presents results of a preliminary examination of perceptions of disease management in youth with T1D and their peers. Data were collected using a mixed methods (qualitative and quantitative data) approach during medical education time at a camp for youth with T1D and their peers. Results suggest that both youth with T1D and their peers believe that peers need more information about medical consequences of having diabetes. Further, youth with T1D and their peers would like coaching on how peers may help the child with T1D manage their illness better. Results provide preliminary ideas for intervention (i.e., including peers, assessing social support) in the medical setting as well as ideas for future research (i.e., examining relationships among perceptions and gender, time since diagnosis).     

Use of a structured investigative protocol enhances the quality of investigative interviews with alleged victims of child sexual abuse in Britain

One hundred alleged victims of child sexual abuse (aged 4–13; M = 9.3 years) were interviewed by police investigators about their alleged experiences. Half of the children were interviewed using the National Institute of Child Health and Human Development (NICHD) structured interview Protocol, whereas the other children, matched with respect to their age, relationship with the alleged perpetrator, and seriousness of the alleged offenses, were interviewed by investigators following the Memorandum of Good Practice. Protocol‐guided interviews elicited more information using free‐recall invitations and less information using directive, option‐posing and suggestive questions than did standard Memorandum interviews. There were no age differences in the proportion of total information provided in response to open‐ended invitations in either condition, but there was a significant increase with age in the proportion of central information provided in response to open‐ended invitations. Published in 2008 by John Wiley & Sons, Ltd.     

FUNCTIONAL ANALYSIS AND TREATMENT OF MULTIPLY CONTROLLED INAPPROPRIATE MEALTIME BEHAVIOR

Functional analyses identified children whose inappropriate mealtime behavior was maintained by escape and adult attention. Function‐based extinction procedures were tested individually and in combination. Attention extinction alone did not result in decreases in inappropriate mealtime behavior or a significant increase in acceptance. By contrast, escape extinction alone resulted in a decrease in inappropriate mealtime behavior and an increase in acceptance. However, inappropriate mealtime behavior did not decrease to clinically acceptable levels. A combined extinction technique (i.e., escape and attention extinction) resulted in a decrease in inappropriate mealtime behavior to clinically acceptable levels and high and stable acceptance.     

ESTABLISHING DERIVED TEXTUAL CONTROL IN ACTIVITY SCHEDULES WITH CHILDREN WITH AUTISM

Activity schedules are often used to facilitate task engagement and transition for children with autism. This study evaluated whether conditional discrimination training would serve to transfer the control from activity‐schedule pictures to printed words (i.e., derived textual control). Two preschoolers with autism were taught to select pictures and printed words given their dictated names. Following training, participants could respond to printed words by completing the depicted task, match printed words to pictures, and read printed words without explicit training (i.e., emergent relations).     

Eating behavior in obese BED, obese non-BED, and non-obese control participants: A naturalistic study

Laboratory studies have shown considerable differences between the eating behavior, particularly binge eating behavior, of participants with and without binge eating disorder (BED). However, these findings were not replicated in two field experiments employing ecological momentary assessment (EMA) in which obese BED and obese non-BED participants reported comparable binge eating behavior. In the current study, we examined differences in binge eating with an innovative assessment scheme employing both EMA and a standardized computer-based dietary recall program to avoid some of the limitations of past laboratory and field research. Obese BED, obese non-BED, and non-obese control participants reported significant differences in eating patterns, loss of control, overeating, and binge eating behavior. Of particular importance was the finding that BED participants engaged in more overeating and more binge eating episodes than non-BED participants. These findings suggest that the use of EMA in combination with dietary recall may be a relatively objective and useful approach to assessing binge eating behavior. The findings further suggest that individuals with BED are observably different from those without the disorder, which may have implications for eating disorder diagnoses in DSM-V.