A Model of Therapist Competencies for the Empirically Supported Cognitive Behavioral Treatment of Child and Adolescent Anxiety and Depressive Disorders

While a plethora of cognitive behavioral empirically supported treatments (ESTs) are available for treating child and adolescent anxiety and depressive disorders, research has shown that these are not as effective when implemented in routine practice settings. Research is now indicating that is partly due to ineffective EST training methods, resulting in a lack of therapist competence. However, at present, the specific competencies that are required for the effective implementation of ESTs for this population are unknown, making the development of more effective EST training difficult. This study therefore aimed to develop a model of therapist competencies for the empirically supported cognitive behavioral treatment of child and adolescent anxiety and depressive disorders using a version of the well-established Delphi technique. In doing so, the authors: (1) identified and reviewed cognitive behavioral ESTs for child and adolescent anxiety and depressive disorders, (2) extracted therapist competencies required to implement each treatment effectively, (3) validated these competency lists with EST authors, (4) consulted with a panel of relevant local experts to generate an overall model of therapist competence for the empirically supported cognitive behavioral treatment of child and adolescent anxiety and depressive disorders, and (5) validated the overall model with EST manual authors and relevant international experts. The resultant model offers an empirically derived set of competencies necessary for effectively treating children and adolescents with anxiety and depressive disorders and has wide implications for the development of therapist training, competence assessment measures, and evidence-based practice guidelines for working with this population. This model thus brings us one step closer to bridging the gap between science and practice when treating child and adolescent anxiety and depression.     

The role of socio-communicative rearing environments in the development of social and physical cognition in apes

The cultural intelligence hypothesis (CIH) claims that humans’ advanced cognition is a direct result of human culture and that children are uniquely specialized to absorb and utilize this cultural experience ( Tomasello, 2000 ). Comparative data demonstrating that 2.5‐year‐old human children outperform apes on measures of social cognition but not on measures of physical cognition support this claim ( Herrmann et al., 2007 ). However, the previous study failed to control for rearing when comparing these two species. Specifically, the human children were raised in a human culture whereas the apes were raised in standard sanctuary settings. To further explore the CIH, here we compared the performance on multiple measures of social and physical cognition in a group of standard reared apes raised in conditions typical of zoo and biomedical laboratory settings to that of apes reared in an enculturated socio‐communicatively rich environment. Overall, the enculturated apes significantly outperformed their standard reared counterparts on the cognitive tasks and this was particularly true for measures of communication. Furthermore, the performance of the enculturated apes was very similar to previously reported data from 2.5‐year‐old children. We conclude that apes who are reared in a human‐like socio‐communicatively rich environment develop superior communicative abilities compared to apes reared in standard laboratory settings, which supports some assumptions of the cultural intelligence hypothesis.     

Design of the Steps to Health Study of Physical Activity in Survivors of Endometrial Cancer: Testing a Social Cognitive Theory Model

Physical activity has been shown to benefit cancer survivors' physical functioning, emotional well-being, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations.     

Regulatory fit and persuasion: transfer from "Feeling Right."

The authors propose that when a message recipient "feels right" from regulatory fit (E. T. Higgins, 2000), this subjective experience transfers to the persuasion context and serves as information for relevant evaluations, including perceived message persuasiveness and opinions of the topic. Fit was induced either by strategic framing of message arguments in a way that fit/did not fit with the recipient's regulatory state or by a source unrelated to the message itself. Across 4 studies, regulatory fit enhanced perceived persuasiveness and opinion ratings. These effects were eliminated when the correct source of feeling right was made salient before message exposure, supporting the misattribution account. These effects reversed when message-related thoughts were negative, supporting the claim that fit provides information about the "rightness" of one's (positive or negative) evaluations.     

Equating tasks and sustaining attention in children and adults: the methodological and theoretical utility of d' matching

The present study develops a method to create task equivalency for children and adults in vigilance research. Experiment 1 employed the signal detection index of perceptual sensitivity (d') to calibrate vigilance tasks for 32 children (ages 7-8) and 32 adults. The results of Experiment 1 suggest that task equivalency across groups can be attained, and a vigilance decrement was observed for children. In Experiment 2, the task parameter of event rate was manipulated across two vigils. Again, 32 children (ages 7-8) and 32 adults participated. The results suggest that a reverse event rate effect emerged for both children and adults. In addition, developmental differences in response to the event rate manipulation and with respect to the vigilance decrement emerged: Children benefited less from the manipulation and were more likely to demonstrate a vigilance decrement than were adults. No developmental differences emerged for the sensitivity decrement. The results are explained with reference to how task demands interact with participant arousal, and implications for development and for future research are discussed.     

Psychological factors in deliberate self-harm as seen in a urban African population in Uganda: a case-control study

Psychological factors associated with deliberate self-harm (DSH) as seen in an African population in Uganda are described. A case-control study design was employed in which a Luganda version (predominant language in the study area) of the modified European Parasuicide Interview Schedule I (EPSIS I) was used to collect data. The controls were patients admitted to the participating hospitals for non-recurrent medical conditions. Hopelessness, global psychological distress, and state anger, but not depression, were significantly associated with DSH after controlling for other factors. Both depression and hopelessness were significantly associated with suicidal intent independent of each other. Differences were observed on the psychological factors associated with suicidal intent in the different age/sex groups and in the depressed/nondepressed group. Interventions for DSH in this population should include treatments for both depression and hopelessness. This study further raises questions about the universality of the structural relationship among depression, hopelessness, and suicidality.     

Contingency experiences of 3-month-old children and their relation to later developmental achievements

In this study, the authors investigated the relation between early social contingency experiences and infants' competencies to detect nonsocial contingencies. In this study of 87 three-month-old infants, the authors operationalized early social contingencies as prompt, contingent maternal responses and coded microanalytically on the basis of video-recorded mother-infant interactions. The authors assessed competence to detect nonsocial contingencies by 2 methods: (a) the mobile conjugate reinforcement paradigm, which focuses on detecting contingencies between the infants' actions (kicking) and nonsocial consequences (mobile moving) and (b) the visual expectation paradigm, which focuses on detecting contingencies between 1 event (a smiley face projected on a screen) that was followed by a 2nd event (a complex picture projected on the other side of the screen). The results showed that early social contingencies are related to the competency to detect nonsocial action-consequence contingencies in the mobile conjugate reinforcement paradigm.     

The scaling of postural adjustments during bimanual load-lifting in traumatic brain-injured adults

Previous postural studies of traumatic brain injury (TBI) patients have been limited to identifying deficits in static and quasi-dynamic postural control tasks such as weight shifting. In this study, we examined whether or not patients with TBI are able to scale adequately their postural adjustments during the performance of the dynamic task of bimanual load-lifting. An age matched group of healthy adults served as controls. We used the Tetrax posturography system that calculates a stability score (ST) based on fluctuations in vertical ground reaction forces, normalized for body weight. During quiet standing, the ST scores of the TBI group were significantly higher than the control group. Forward weight shift and percentage change in the vertical ground reaction forces (lift postural adjustment (LPA) and post-lift postural adjustment (PLPA) scores) linearly increased with increasing load weight in both healthy and TBI subjects. Group differences were found in the magnitude of forward weight shift but not in the relative increase of the LPA and PLPA scores during the lifting and post-lifting phases respectively. The forward weight shift of the TBI group was lower-than-normal and asymmetrical--there was significantly less forward weight shift on the more affected than on the less affected limb. In addition, a significant amplitude coupling was found between the scaling of the weight shift of the heel and forefoot of each limb. However, no coupling was found between the weight shift amplitudes of homologous parts of both limbs in the TBI group. The results showed that scaling based on prior experience was preserved in the TBI group, though some TBI subjects demonstrated absent scaling in either the more affected or less affected heel or forefoot. The differences between the normal and TBI groups in postural adjustments are not necessarily a sign of pathology; rather they may represent a deliberate choice of the central nervous system to counteract predictable disturbances.     

Ethical issues surrounding human participants research using the Internet

The Internet appears to offer psychologists doing research unrestricted access to infinite amounts and types of data. However, the ethical issues surrounding the use of data and data collection methods are challenging research review boards at many institutions. This article illuminates some of the obstacles facing researchers who wish to take advantage of the Internet's flexibility. The applications of the APA ethical codes for conducting research on human participants on the Internet are reviewed. The principle of beneficence, as well as privacy and confidentiality, informed consent, deception, and avoiding harm are all illustrated through the use of a hypothetical online study.     

Phonological memory and vocabulary learning in children with focal lesions

Eleven children with early focal lesions were compared with 70 age-matched controls to assess their performance in repeating non-words, in learning new words, and in immediate serial recall, a triad of abilities that are believed to share a dependence on serial ordering mechanisms (e.g.,; ). Results for the experimental group were also compared with other assessments previously reported for the same children by. The children with brain injury showed substantial impairment relative to controls in the experimental tasks, in contrast with relatively unimpaired performance on measures of vocabulary and non-verbal intelligence. The relationships between word learning, non-word repetition, and immediate serial recall were similar to those observed in several other populations. These results support previous reports that there are persistent processing impairments following early brain injury, despite developmental plasticity. They also suggest that word learning, non-word repetition, and immediate serial recall may be relatively demanding tasks, and that their relationship is a fundamental aspect of the cognitive system.