Challenges using motivational interviewing as an adjunct to exposure therapy for obsessive-compulsive disorder

Exposure and response prevention (EX/RP) is an efficacious treatment for obsessive-compulsive disorder (OCD). However, patients often do not adhere fully to EX/RP procedures. Motivational interviewing (MI) has been shown to improve treatment adherence in other disorders. This pilot study used a randomized controlled design to examine whether MI can be successfully added to EX/RP and whether this intervention (EX/RP + MI) could improve patient adherence to between-session EX/RP procedures relative to EX/RP alone. Thirty adults with OCD were randomized to 18 sessions of EX/RP or EX/RP + MI. Therapists rated patient adherence at each exposure session. Independent evaluators assessed change in OCD and depressive symptoms, and patients completed self-report measures of readiness for change and quality of life. The two treatment conditions differed in degree of congruence with MI but not in conduct of EX/RP procedures. Both groups experienced clinically significant improvement in OCD symptoms, without significant group differences in patient adherence. There are several possible reasons why EX/RP + MI had no effect on patient adherence compared to standard EX/RP, each of which has important implications for the design of future MI studies in OCD. We recommend that MI be further evaluated in OCD by exploring alternative modes of delivery and by focusing on patients less ready for change than the current sample.     

Exploring the Effects of Rational Emotive Behavior Therapy on the Irrational Beliefs and Self-Determined Motivation of Triathletes

The present study addresses proposals that Rational Emotive Behavior Therapy (REBT) can influence self-determined motivation. Triathletes received REBT education, followed by either Rational Emotive Personal-Disclosure Mutual-Sharing (REPDMS) or Personal-Disclosure Mutual-Sharing. Measurements of irrational beliefs and self-determined motivation were collected prior to REBT (baseline), during the REBT education period, and after the REPDMS session (postintervention). An ABC single-case design was adopted, allowing for statistical and visual analysis of data over time and between groups. Findings indicate that REBT led to decreased irrational beliefs and increased self-determined motivation. REPDMS appeared to have no influence on irrational beliefs over and above REBT education.     

Spinoza's environmental ethics

The paper explores an apparent tension in Spinoza's thought between his treatment of man as part of nature, with no specially privileged position within it; and his treatment of morality as circumscribed by what is good for human beings. These two themes, it is argued, are in fact interconnected in Spinoza's thought. The paper goes on to consider some possible responses, from a contemporary standpoint, to Spinoza's rejection of animal rights. Finally, it is argued that the apparent tension in Spinoza's thought becomes more understandable in the light of his treatment of the importance of truth to human beings; and that this throws into relief some puzzling features of some contemporary formulations of the theme of man as part of nature.     

Reformed and evolutionary epistemology and the noetic effects of sin

Despite their divergent metaphysical assumptions, Reformed and evolutionary epistemologists have converged on the notion of proper basicality. Where Reformed epistemologists appeal to God, who has designed the mind in such a way that it successfully aims at the truth, evolutionary epistemologists appeal to natural selection as a mechanism that favors truth-preserving cognitive capacities. This paper investigates whether Reformed and evolutionary epistemological accounts of theistic belief are compatible. We will argue that their chief incompatibility lies in the noetic effects of sin and what may be termed the noetic effects of evolution, systematic tendencies wherein human cognitive faculties go awry. We propose a reconceptualization of the noetic effects of sin to mitigate this tension.     

Stress at encoding,context at retrieval,and children’s narrative content

Research concerning the relations between stress and children’s memory has been primarily correlational and focused on memory volume and accuracy. In the current study, we experimentally manipulated 7- and 8-year-olds’ and 12- to 14-year-olds’ experienced stress during a to-be-remembered event to examine the effects of stress on the content of their memory. We further manipulated the degree of interviewer support at retrieval to determine whether it moderated the effects of stress at encoding on memory. Children’s age, gender, stress at encoding, and interviewer support all influenced the type of information included in their narrative reports. Most notably, across ages, children who experienced a more stressful event but were questioned in a supportive manner provided the largest ratio of terms representing internal states such as those about cognitions and emotions. Results suggest that how children process past events may be influenced by both the nature of the event itself and the context within which it is recalled.     

Replacement in Logic

We study a range of issues connected with the idea of replacing one formula by another in a fixed (linguistic) context. The replacement core of a consequence relation ? is the relation holding between a set of formulas {A ₁, ..., A _m , ...} and a formula B when for every context C(·), we have C(A ₁), ..., C(A _m ), ...???C(B). Section 1 looks at some differences between which inferences are lost on passing to the replacement cores of the classical and intuitionistic consequence relations. For example, we find that while the inference from A and B to $A \land B$ , sanctioned by both these initial consequence relations, is retained on passage to the replacement core in the classical case, it is lost in the intuitionistic case. Further discussion of these two (and some other) logics occupies Sections 3 and 4. Section 2 looks at the m?=?1 case, describing A as replaceable by B according to ? when B is a consequence of A by the replacement core of ?, and inquiring as to which choices of ? render this induced replaceability relation symmetric. Section 5 investigates further conceptual refinements— such as a contrast between horizontal and vertical replaceability—suggested by some work of R. B. Angell and R. Harrop (and a comment on the latter by T. J. Smiley) in the 1950s and 1960s. Appendix 1 examines a related aspect of term-for-term replacement in connection with identity in predicate logic. Appendix 2 is a repository for proofs which would otherwise clutter up Section 3.     

Adolescents' Reactions to the Evacuation of the Sinai Settlements: A Longitudinal Study

This study investigated psychological reactions of adolescents to a severe stress situation—the evacuation of the Sinai settlements. The research focused on emotional reactions of anxiety and anger to this stress situation. Two central problems were investigated: (a) The intensity of the emotional responses of anxiety and anger of the adolescents to the stress situation, before and after the evacuation, and (b) the impact of three intervening variables on these emotional reactions—cognitive perception of the political situation, family functioning, and personality characteristics. Data for this study were collected in a regional high school in Israel from 418 pupils in 9th through 12th grades. Seventy-eight of the pupils lived in the Yamit area. Measurements were obtained at three points in time: 6 weeks and 1 week before the evacuation and 2 months after it. The results supported the predicted trend that adolescents in the Yamit group before the evacuation would score higher on state anxiety and state anger than would those in the comparison group. Two months after the evacuation there was a significant drop in those scores. The trait measures remained stable in both groups and no significant differences were found between the two groups on these scores. Concerning the impact of the three intervening variables on the intensity of the state emotional responses, the results did not support any of the hypotheses.