Integrated Behavior Therapy for Selective Mutism: A randomized controlled pilot study

Objective

To evaluate the feasibility, acceptability, and preliminary efficacy of a novel behavioral intervention for reducing symptoms of selective mutism and increasing functional speech.

Method

A total of 21 children ages 4 to 8 with primary selective mutism were randomized to 24 weeks of Integrated Behavior Therapy for Selective Mutism (IBTSM) or a 12-week Waitlist control. Clinical outcomes were assessed using blind independent evaluators, parent-, and teacher-report, and an objective behavioral measure. Treatment recipients completed a three-month follow-up to assess durability of treatment gains.

Results

Data indicated increased functional speaking behavior post-treatment as rated by parents and teachers, with a high rate of treatment responders as rated by blind independent evaluators (75%). Conversely, children in the Waitlist comparison group did not experience significant improvements in speaking behaviors. Children who received IBTSM also demonstrated significant improvements in number of words spoken at school compared to baseline, however, significant group differences did not emerge. Treatment recipients also experienced significant reductions in social anxiety per parent, but not teacher, report. Clinical gains were maintained over 3 month follow-up.

Conclusion

IBTSM appears to be a promising new intervention that is efficacious in increasing functional speaking behaviors, feasible, and acceptable to parents and teachers.     

Scattered Exemplification and Many-Place Copulas

Can there be relational universals? If so, how can they be exemplified? A monadic universal is by definition capable of having a scattered spatiotemporal localization of its different exemplifications, but the problem of relational universals is that one single exemplification seems to have to be scattered in the many places where the relata are. The paper argues that it is possible to bite this bullet, and to accept a hitherto un-discussed kind of exemplification relation called ‘scattered exemplification’. It has no immediate symbolic counterpart in any Indo-European natural language or in any so far constructed logical language. In order to remedy this, a notion called ‘many-place copula’ is introduced, too.     

C. S. Peirce’s Dialogical Conception of Sign Processes

This article examines the contention that the central concepts of C. S. Peirce’s semeiotic are inherently communicational. It is argued that the Peircean approach avoids the pitfalls of objectivism and constructivism, rendering the sign-user neither a passive recipient nor an omnipotent creator of meaning. Consequently, semeiotic may serve as a useful general framework for studies of learning processes.     

Gains in fluid intelligence after training non-verbal reasoning in 4-year-old children: a controlled, randomized study

Fluid intelligence (Gf) predicts performance on a wide range of cognitive activities, and children with impaired Gf often experience academic difficulties. Previous attempts to improve Gf have been hampered by poor control conditions and single outcome measures. It is thus still an open question whether Gf can be improved by training. This study included 4-year-old children (N = 101) who performed computerized training (15 min/day for 25 days) of either non-verbal reasoning, working memory, a combination of both, or a placebo version of the combined training. Compared to the placebo group, the non-verbal reasoning training group improved significantly on Gf when analysed as a latent variable of several reasoning tasks. Smaller gains on problem solving tests were seen in the combination training group. The group training working memory improved on measures of working memory, but not on problem solving tests. This study shows that it is possible to improve Gf with training, which could have implications for early interventions in children.     

Residual differences in language processing in compensated dyslexics revealed in simple word reading tasks

Using regional cerebral blood flow as an index of cerebral activity we studied dyslexic and control subjects during simple word reading tasks. The groups were pre-tested for reading skill and the dyslexic group had a lower reading performance but could read and comprehend standard texts. The aim was to elucidate differences in the cerebral activation pattern during reading. The tasks were simple enough that performance differences between the groups could be excluded. We found specific differences between the two groups that were dependent on the language task. When the visual route for language information was used, minor qualitative differences were found between the groups pertaining to the dominant hemisphere. Increasing the complexity of the task by using pseudowords activated the left frontal region more in the dyslexic group than in the control group. A similar effect was seen in a minor region in extrastriate lateral occipital cortex (BA 19). This finding indicates that the dyslexics used areas in these regions that the controls did not. On the other hand, the dyslexics activated less in the right angular gyrus, right dorsolateral prefrontal cortex, and in the right pallidum. Reading skill correlated with the level of activity in the right frontal cortex. We conclude, that cerebral activation pattern elicited by reading is different in dyslexics compared to controls in spite of an almost complete functional compensation.     

Social contagion of memory

We report a new paradigm for studying false memories implanted by social influence, a process we call the social contagion of memory. A subject and confederate together saw six common household scenes (e.g., a kitchen) containing many objects, for either 15 or 60 sec. During a collaborative recall test, the 2 subjects each recalled six items from the scenes, but the confederate occasionally made mistakes by reporting items not from the scene. Some intrusions were highly consistent with the scene schema (e.g., a toaster) while others were less so (e.g., oven mitts). After a brief delay, the individual subject tried to recall as many items as possible from the six scenes. Recall of the erroneous items suggested by the confederate was greater than in a control condition (with no suggestion). Further, this social contagion effect was greater when the scenes were presented for less time (15 sec) and when the intruded item was more schema consistent (e.g., the toaster). As with other forms of social influence, false memories are contagious; one person’s memory can be infected by another person’s errors.     

Attachment patterns moderate the relation between coping flexibility and illness acceptance among kidney transplant recipients

Background and Objectives: Post-transplant kidney recipients may experience psychological concerns which have been associated with negative health behaviors. Illness acceptance might have an important role in this process. In line with the Conservation of Resources Theory (COR), the current study aimed to examine the relationship between coping flexibility, attachment patterns and illness acceptance among post-transplant kidney recipients, and to evaluate whether attachment patterns moderate the link between coping flexibility and illness acceptance.

Design: The study employed a cross-sectional design.

Methods: Ninety-four post-transplant kidney recipients completed questionnaires assessing demographic and medical characteristics, illness acceptance, coping flexibility and attachment patterns.

Results: Our results indicated that coping flexibility was positively associated with illness acceptance. Moreover, attachment moderated this link, as high coping flexibility was associated with increased illness acceptance among individuals with low levels of attachment anxiety, a finding which was not significant when high levels of anxiety were reported.

Conclusions: This study highlights the potential importance of building greater flexibility in order to enhance illness acceptance among kidney transplants recipients. Moreover, the role of insecure attachment patterns in health-related outcomes among kidney transplants recipients is emphasized.     

Individually tailored internet-based cognitive behaviour therapy for older adults with anxiety and depression: a randomised controlled trial

Mixed anxiety and depression is common among older adults. The aim of the study was to compare the effects of an eight-week-long tailored internet-supported cognitive behaviour therapy (ICBT) programme and to compare against the provision of weekly general support. A second aim was to investigate if pre-treatment cognitive flexibility and self-reported cognitive problems would predict outcome. We included 66 older adults (aged over 60 years) with mixed anxiety/depression following media recruitment and randomised them into treatment and control groups. We also included a one-year follow-up. As a measure of executive function, we used the Wisconsin Card Sorting Test (perseverative errors) and the Cognitive Failures Questionnaire during the pre-treatment phase. Results showed a moderate between-group effect on the main outcome measure, the Beck Anxiety Inventory (BAI) (d= .50), favouring the treatment group. Nearly half (45.5%) of that group were classified as responders. One person (3%) in the treatment group deteriorated. There were significant correlations between perseverative errors and outcome (on the BAI r = ?.45), but not among self-reported cognitive function. We conclude that guided, tailored ICBT may be effective for some older adults and that the role of cognitive function needs to be investigated further.     

The validity of DSM-IV passive-aggressive (negativistic) personality disorder

Passive-Aggressive (Negativistic) Personality Disorder (NEGPD), listed in Appendix B of the DSM-IV, is not an officially recognized personality disorder. Its future as a discrete disorder is uncertain (Widiger, 2003). Yet, NEGPD occupies a role in some theoretical formulations of personality pathology (Millon & Davis, 1996), and many clinicians believe that passive-aggressive traits are not adequately represented by other PDs (Westen, 1997). In this study, 1158 psychiatric outpatients were assessed for Axis I and Axis II disorders. Thirty-five (3.02%) met criteria for NEGPD. Participants with NEGPD did not differ significantly from those without NEGPD on demographic variables. The internal consistency of the DSM-IV's seven NEGPD items was 0.50. Corrected item- total correlations for the 7 criteria averaged 0.27. Participants with NEGPD had higher rates of lifetime anxiety disorders, and almost 90% had an additional PD. An exploratory factor analysis suggested a two- factor solution that accounted for 43.4% of the variance. The first factor reflected the belief that life is unfair, while the second factor seemed to reflect modes of anger expression. A confirmatory factor analysis showed that the two-factor model fit the data better than a unidimensional model. We discuss implications of these results for the future of the NEGPD diagnosis.