The relationship between acute stress disorder and posttraumatic stress disorder in severely injured trauma survivors

This prospective longitudinal study was designed to investigate the relationship between acute stress disorder (ASD) and the subsequent development of posttraumatic stress disorder (PTSD) in a population of severely injured hospitalised trauma survivors. Symptoms of ASD were assessed just prior to discharge in 307 consecutive admissions to a Level 1 Trauma Centre, with PTSD assessments completed at 3 and 12 months post-injury. A well-established structured clinical interview was adopted for both assessments. Only 1% of the sample met criteria for an ASD diagnosis (at a mean of 8 days post-injury), while the incidence of PTSD was 9% at 3 months and 10% at 12 months. Although all ASD symptom clusters contributed to the prediction of subsequent PTSD severity, logistic regression indicated that only re-experiencing and arousal predicted a categorical PTSD diagnosis. The dissociative symptoms that form the core of ASD were rarely endorsed and showed high specificity but low sensitivity, resulting in a high proportion of false negative diagnoses. Reducing the number of dissociative symptoms required for a diagnosis ameliorated, but did not resolve, the problem. In this particular population, the low sensitivity of the ASD diagnosis renders it a poor screening test for use in identifying high risk individuals for early intervention and prevention strategies.     

The “false consensus effect”: An egocentric bias in social perception and attribution processes

Evidence from four studies demonstrates that social observers tend to perceive a “false consensus” with respect to the relative commonness of their own responses. A related bias was shown to exist in the observers' social inferences. Thus, raters estimated particular responses to be relatively common and relatively unrevealing concerning the actors' distinguishing personal dispositions when the responses in question were similar to the raters' own responses; responses differing from those of the rater, by contrast, were perceived to be relatively uncommon and revealing of the actor. These results were obtained both in questionnaire studies presenting subjects with hypothetical situations and choices and in authentic conflict situations. The implications of these findings for our understanding of social perception phenomena and for our analysis of the divergent perceptions of actors and observers are discussed. Finally, cognitive and perceptual mechanisms are proposed which might account for distortions in perceived consensus and for corresponding biases in social inference and attributional processes.     

Effects of knowledge that attributions will be observed by others

The current study was conducted to determine if attribution statements would be affected by subjects' knowledge that their attributions of success or failure would be observed by an opposite-sex peer. At the time subjects recorded their attributions, half of them anticipated that their attributions would soon be observed in their presence by an opposite-sex peer, while the other half recorded their attributions anonymously. Results indicated that attributions of success and failure were affected by the social context. Observed subjects evidenced less tendency to attribute their failure to low ability than did nonobserved subjects. Subjects who succeeded on an identity-relevant task reported higher ability attributions under observation conditions than under nonobservation conditions. Observed subjects evidenced significantly greater willingness to attribute failure to lack of effort than did nonobserved subjects. For a task intended to be of minimal relevance to subjects' identities, nonobserved subjects attributed failure to task difficulty to a significantly greater degree than did observed subjects. Results were discussed in relation to Bradley's contention that self-serving biases in attribution can usefully be conceptualized as strategic self-presentations.     

Therapeutic immediacy across long-term psychodynamic psychotherapy: an evidence-based case study

C. E. Hill (2004) recently developed the concept of therapist immediacy to capture discussion by the therapist about the therapeutic relationship that occurs in the here-and-now of a therapy session. This concept has been expanded to include discussion about the therapeutic relationship by both the client and therapist, captured by the term therapeutic immediacy (K. Kuutmann & M. Hilsenroth, 2011). Although prior research has examined the use of therapeutic immediacy across short-term treatment, the present study is the first to examine the use of immediacy across a long-term (4 years) psychotherapy. Also, this is the first study to assess the interrater reliability of therapeutic immediacy, which was found to achieve good to excellent levels across raters. The most frequently used categories of client and therapist immediacy are presented. Finally, the authors provide an in-depth qualitative examination of 5 therapeutic immediacy segments across the treatment judged by the raters to have high levels of depth/intensity (4.5 or higher out of 5) to examine the role of therapeutic immediacy in exploring meaningful treatment issues. Clinical utility, potential limitations, and future research on therapeutic immediacy are discussed.     

Comparing Self-Regulation-Associated Event Related Potentials in Preschool Children with and without High Levels of Disruptive Behavior

Deficient self-regulation plays a key role in the etiology of early onset disruptive behavior disorders and signals risk for chronic psychopathology. However, to date, there has been no research comparing preschool children with and without high levels of disruptive behavior using Event Related Potentials (ERPs) associated with specific self-regulation sub-processes. We examined 15 preschool children with high levels of disruptive behavior (35 % female) and 20 peers with low disruptive behavior (50 % female) who completed a Go/No-go task that provided emotionally valenced feedback. We tested whether 4 ERP components: the Error Related Negativity, the Error Positivity, the Feedback Related Negativity, and the No-go N2, differed in preschool children with and without high levels of disruptive behavior. Preschoolers with high levels of disruptive behavior showed less differentiation between the Error Positivity and corresponding waveforms following correct responses at posterior sites. Preschoolers with high and low disruptive behavior also showed differences in Go/No-go N2 waveform amplitudes across electrodes. These findings suggest that preschool children with high levels of disruptive behavior may show abnormal brain activity during certain self-regulation sub-processes, informing potential advances in conceptualizing and treating early disruptive behavior.     

Language-based access to gestural components of conceptual knowledge

We report two experiments in which production of articulated hand gestures was used to reveal the nature of gestural knowledge evoked by sentences referring to manipulable objects. Two gesture types were examined: functional gestures (executed when using an object for its intended purpose) and volumetric gestures (used when picking up an object simply to move it). Participants read aloud a sentence that referred to an object but did not mention any form of manual interaction (e.g., Jane forgot the calculator) and were cued after a delay of 300 or 750 ms to produce the functional or volumetric gesture associated with the object, or a gesture that was unrelated to the object. At both cue delays, functional gestures were primed relative to unrelated gestures, but no significant priming was found for volumetric gestures. Our findings elucidate the types of motor representations that are directly linked to the meaning of words referring to manipulable objects in sentences.