Cognitive-Behavioral Therapy for Insomnia Co-Morbid with Hearing Impairment: A Randomized Controlled Trial

The purpose of the current study was to examine the effects of cognitive behavior therapy (CBT-I) for insomnia on patients with insomnia co-morbid with hearing impairment. A randomized controlled design was used with a 3-month follow-up. Thirty-two patients with insomnia co-morbid with hearing impairment were randomized to either CBT-I or a waitlist condition (WLC). The primary outcome was insomnia severity. Secondary outcomes were sleep diary parameters, dysfunction, anxiety, and depression. Compared to WLC, CBT-I resulted in lower insomnia severity at post-treatment and at follow-up (d = 1.18–1.56). Relative to WLC, CBT-I also led, at both assessment points, to reduced total wake time (d = 1.39) and increased sleep restoration (d = 1.03–1.07) and sleep quality (d = 0.91–1.16). Both groups increased their total sleep time, but no significant group difference emerged. Compared to WLC, CBT-I resulted in higher function (d = 0.81–0.96) and lower anxiety (d = 1.29–1.30) at both assessment points. Neither CBT-I nor WLC led to improvement on depression. Based on the Insomnia Severity Index, more CBT-I (53–77%) than WLC participants (0–7%) were treatment responders. Also, more CBT-I (24%) than WLC participants (0%) remitted. In patients with insomnia co-morbid with hearing impairment, CBT-I was effective in decreasing insomnia severity, subjective sleep parameters, dysfunction, and anxiety. These findings are in line with previous results on the effects of CBT-I in other medical conditions.     

Avoidant coping in panic disorder: a yohimbine biological challenge study

Few studies have addressed whether the use of avoidance-oriented coping strategies is related to the development of panic in patients with panic disorder(PD). Self-report, clinician-rated, and physiological data were collected from 42 individuals who participated in a yohimbine biological challenge study, performed under double-blind, placebo-controlled conditions. Participants included 20 healthy controls and 22 currently symptomatic patients who met DSM-IV-TR diagnostic criteria for PD. Consistent with prediction, patients with PD who had higher perceived efficacy of avoidance-oriented strategies in reducing anxiety-related thoughts reported increased severity in panic symptoms during the yohimbine challenge condition as compared to the placebo. Further, patients with PD who had more fear of cognitive dyscontrol, cardiovascular symptoms, and publicly observable anxiety also reported increased severity in panic symptoms during the challenge. Healthy controls who had more fear of cardiovascular symptoms similarly reported increased severity in panic symptoms during the challenge. No effects were found for heart rate response to the challenge agent. These results provide support for the role of avoidance-oriented coping strategies and fear of anxiety-related symptoms as risk and maintenance factors in the development of panic symptoms, particularly within a biological challenge model.     

Obedience and Disobedience/Rebellion in Biblical Versus Greek Narratives: Toward a Biblical Psychology

Contemporary psychology and psychiatry have been explicitly or implicitly based on an ancient Greek view of life. Even pastoral psychologists have been influenced by this view. The present article calls for a paradigm shift toward a biblical psychology. Illustrations of these contrasting worldviews are presented around the issue of obedience versus disobedience/rebellion. Three narratives are compared in this regard: 1) creation stories, 2) “flood” stories, and 3) father-son stories. Freud’s dependence on a Greek worldview is discussed, as is his disregard of biblical narratives. Pastoral psychologists, take heart! It is time to level the playing field.     

Rates and correlates of undetermined deaths among African Americans: results from the National Violent Death Reporting System

Little is known about the factors associated with undetermined death classifications among African Americans. In this study, the rates of undetermined deaths were assessed, the prevalence of missing information was estimated, and whether the circumstances preceding death differ by race were examined. Data were derived from the 2005-2008 National Violent Death Reporting System. African Americans had higher prevalence of missing information than Whites. African Americans classified as undetermined deaths were more likely to be older, women, never married/single, to have had a blood alcohol content at or above the legal limit, and to have had a substance abuse problem. The results suggest that racial differences in the preponderance and the type of evidence surrounding the death may affect death classification.     

Maternal depression and expressive communication in one-year-old infants

To separate effects of maternal depression on infant cognitive versus language development, 1-year-olds were assessed using the revised Bayley Scales of Infant and Toddler Development (BSID-III). Percentile scores on the Bayley Expressive Communication (EC) subscale were significantly negatively correlated with maternal self-report scores on the Beck Depression Inventory (BDI-II). However, mothers’ BDI-II scores did not correlate with infant percentile scores on the general cognitive (COG) or receptive communication (RC) subscales. Boys had significantly lower percentile scores than girls on the RC and EC scales, but did not differ on the Cog scale. Gender and maternal depression did not significantly interact on any of the scales. These findings suggest problems with expressive communication precede, and may at least partially account for, apparent deficits in general cognitive development.     

Ethical Implications of a Critical Legal Case for the Counseling Profession: Ward v. Wilbanks

This article presents the official position of the American Counseling Association on a seminal legal case for professional counseling: Ward v. Wilbanks. The focus is on three key questions: Is it permissible to deny counseling services to a homosexual client on the basis of a counselor's values? Can referrals be made at any time a counselor wishes to do so? When is a client a client?     

A Trial of Psychopharmacologic Measurement with Projective Techniques

An interactive computer program was developed in the BASIC language to present the performance and inquiry phases of the Rorschach Inkblot Test. As the subjects handled the traditional cards they entered their perceptions into the computer database, guided by instructions presented on the computer display. No assumptions were made about the percepts, but the Klopfer scoring questions were asked directly by the computer during the inquiry. The program scored the test as the subject answered the scoring questions on the keyboard. Thirty subjects were assessed using a test-retest design. One subgroup was tested first by a psychologist, and the other was tested first by the computer. The determinants of the psychologist and computer testing situations were found to be correlated and overall not significantly different except in location and time scores where the media differed.