"Dwelling in the Past": The Role of Rumination in the Treatment of Posttraumatic Stress Disorder

Prolonged exposure, a cognitive behavioral therapy including both in vivo and imaginal exposure to the traumatic memory, is one of several empirically supported treatments for chronic posttraumatic stress disorder (PTSD). In this article, we provide a case illustration in which this well-validated treatment did not yield expected clinical gains for a client with PTSD and co-occurring major depression. After providing an overview of the literature, theory, and treatment protocol, we discuss the clinical cascade effect that underlying ruminative processes had on the treatment of this case. Specifically, we highlight how ruminative processes, focusing on trying to understand why the traumatic event happened and why the client was still suffering, resulted in profound emotional distress in session and in a lack of an "optimal dose" of exposure during treatment.     

Wanting more than you have and it’s Consequences for Well-being

Americans have a lot of stuff, but are not necessarily happier for it. One possibility is that even if we want what we have, we want more. Wanting more may increase have-want discrepancies and reduce well-being. In this paper, we introduce the construct wanting more, and show that it negatively predicts well-being. We then identify materialism as a mediator of this relationship. Wanting more negatively effects well-being at least in part because those who want more are more likely to be materialistic. Finally, we show that wanting more than one has and wanting what one has are distinct constructs, and that wanting what one has moderates the relationship between wanting more and well-being. Those who want more are less happy only if they also do not want what they have. Wanting what one has may reduce attention to have-want discrepancies that result from wanting more.     

Virtual conversation partner for adults with autism

Autistic Spectrum Disorder (ASD) is notable for severely impaired reciprocal social interaction skills relative to language and intellectual abilities, presenting a major barrier to social integration and vocational success. Evidence-based interventions to address these needs are lacking. We report on the development of a small, prototype conversation simulation to teach conversational skills to adolescents and adults with ASD and average to superior intellectual abilities. We also report on a test of the feasibility and acceptability of the simulation approach with a sample of the target population. The simulation engages the user in a virtual conversation with an on-screen partner whose reactions provide naturalistic feedback geared to the appropriateness of the learner's response choices. The prototype simulation, which provides for up to 12 potentially unique multi-turn conversations, was used over a period of 2 weeks by 16 adolescents and adults who then rated statements about the system on a linear scale of 1 (disagreement) to 5 (high agreement). The participants highly endorsed the majority of positive statements about the quality and credibility of the interaction and the virtual conversation partner. In contrast, agreement with positive statements about instructional features external to the conversation was moderate. Unexpectedly, most participants strongly agreed that using the simulation had been helpful to them. Further development and testing in the context of a controlled study with randomized assignment to control and experimental groups are needed to determine whether this approach is effective in improving real-world pragmatic language behavior of high-functioning adults with ASD.     

The forensic confirmation bias: Problems,perspectives, and proposed solutions

As illustrated by the mistaken, high-profile fingerprint identification of Brandon Mayfield in the Madrid Bomber case, and consistent with a recent critique by the National Academy of Sciences (2009), it is clear that the forensic sciences are subject to contextual bias and fraught with error. In this article, we describe classic psychological research on primacy, expectancy effects, and observer effects, all of which indicate that context can taint people's perceptions, judgments, and behaviors. Then we describe recent studies indicating that confessions and other types of information can set into motion forensic confirmation biases that corrupt lay witness perceptions and memories as well as the judgments of experts in various domains of forensic science. Finally, we propose best practices that would reduce bias in the forensic laboratory as well as its influence in the courts.     

Backward crosstalk effects in psychological refractory period paradigms: effects of second-task response types on first-task response latencies

Three experiments using psychological refractory period (PRP) tasks documented backward crosstalk effects in which the nature of the second-task response influenced the first-task response latencies. Such effects are difficult to explain within currently popular bottleneck models, according to which second-task response selection does not begin until first-task response selection has finished. In Experiments 1 and 2, the first of the PRP tasks required a choice reaction time (RT) response, whereas the second task required a go/no-go decision. Task 1 responses were faster when the second task required a go response than when it required a no-go response. Experiment 3 showed that Task 1 RTs were also influenced by the complexity of second-task responses. These backward crosstalk effects indicate that significant second-task processing is carried out in time to influence first-task responses and thus challenge strictly serial bottleneck models.     

Depression, SSRIs, and the supposed obligation to suffer mentally

Within both popular and academic literature, concerns have been expressed about the implications of antidepressant use on character development. In this paper, I identify specific versions of these worries and argue that they are misguided. I begin by arguing that the obligation to suffer if it will bring about a noble character is imagined. Legitimate concerns about character enhancement remain, but they do not count against most antidepressant use. Thus there is no moral prohibition against antidepressant use. Furthermore, some of the calls for caution about antidepressant use, such as those expressed by the President's Council on Bioethics, are overstated.     

Tinnitus Stages of Change Questionnaire: psychometric development and validation

This study describes the development of the Tinnitus Stages of Change Questionnaire (TSOCQ), which aims to assess the readiness of tinnitus patients to change their behaviors and attitudes in relation to tinnitus. Its ability to predict treatment outcome was also investigated. One hundred and fifty-one patients with tinnitus completed the questionnaire. Through repeated principal component analyses, together with judgments of the factors' theoretical relevance, empirically and clinically meaningful scales were derived. A factor solution in accordance with the transtheoretical model (TTM) and with acceptable psychometric properties was found with the five scales of the TSOCQ labeled Precontemplation (Medical Solution), Precontemplation (Helplessness), Contemplation, Preparation and Action/Maintenance. Participants scoring high on Precontemplation (Helplessness) and low on Action/Maintenance had better treatment outcomes. In conclusion, the TSOCQ had some ability to predict treatment success, but further research is required into the utility of the TTM for understanding the rehabilitation process in tinnitus patients.     

Structural equation modeling with interchangeable dyads

Structural equation modeling (SEM) can be adapted in a relatively straightforward fashion to analyze data from interchangeable dyads (i.e., dyads in which the 2 members cannot be differentiated). The authors describe a general strategy for SEM model estimation, comparison, and fit assessment that can be used with either dyad-level or pairwise (double-entered) dyadic data. They present applications illustrating this approach with the actor-partner interdependence model, confirmatory factor analysis, and latent growth curve analysis.     

Examination of psychiatric symptoms in student athletes

In the present study, the authors examined the severity of psychiatric symptoms in undergraduate recreational (noncompetitive) athletes (n = 64) and National Collegiate Athletic Association (NCAA; competitive) athletes (n = 72). The results indicated that the 2 groups were similar in the severity of psychiatric symptoms. The recreational and NCAA athletes combined (n = 136) showed less severe global psychiatric symptoms when they were compared with an undergraduate control group (n = 435). The implications of the study are discussed in the context of those findings.