Cognitive Behavior Therapy for Fear of Cancer Recurrence: A Case Study

This case study describes the course and content of cognitive behavior therapy (CBT) for clinical fear of cancer recurrence (FCR) in a breast cancer survivor. The CBT for clinical FCR consisted of seven face-to-face therapy sessions and one telephone session. The primary treatment goal was to reduce FCR severity by modifying cognitive processes and dysfunctional behavior. Assessments of FCR and quality of life were completed by the breast cancer survivor pre-therapy, post-therapy, and at 6 and 12 months of post-therapy. In each treatment session, perceived control over FCR was assessed. A clinical nurse specialist participated in evaluation interviews. The patient’s perceived control over FCR increased during the therapy, and FCR severity declined to a non-clinical level. This improvement was still evident at the 6- and 12-month follow-up assessments and was supported by results for secondary and exploratory outcomes measures. FCR offers a great challenge for health care professionals due to the lack of effective treatment options. This case study shows how clinical FCR can be addressed with CBT and can contribute to the improvement of care for cancer survivors.     

Patterns of emotional availability between mothers and young children: Associations with risk factors for borderline personality disorder

Emotional availability (EA) characterizes a warm, close relationship between caregiver and child. We compared patterns (clusters) of EA on risk factors, including those for borderline personality disorder (BPD). We sampled 70 children aged 4 to 7 years from low socio‐economic backgrounds: 51% of whose mothers had BPD. We coded filmed interactions for EA: mothers' sensitivity, structuring, non‐intrusiveness, non‐hostility, and children's responsiveness to, and involvement of, mothers. We additionally coded children's over‐responsiveness and over‐involvement. Using person‐centred analyses, we identified four clusters: high functioning, low functioning, asynchronous (mothers above average on two of four dimensions and children below), and below average. Mothers in the low‐functioning cluster had lower income, less social support, more of the borderline feature of negative relationships, and more depression than did mothers in the high‐functioning cluster. The children in the low‐functioning group had more risk factors for BPD (physical abuse, neglect, and separation from, or loss of caregivers, and negative narrative representations of the mother–child relationship in their stories) than did children in the high‐functioning group. The asynchronous group included older girls who were over‐responsive and over‐involving with their mothers in an apparent role reversal. Interventions targeting emotional availability may provide a buffer for children facing cumulative risks and help prevent psychopathology.

Highlights

• This paper investigated how mother‐child emotional availability (warmth and closeness) relates to risk factors for borderline personality disorder, including mother‐child role reversal.
• In filmed mother‐child interactions, low emotional availability was associated with risk for borderline personality disorder and role reversal was more likely for older girls.
• Findings support the cumulative risk hypothesis and may inform interventions to improve mother‐child emotional availability to prevent the development of psychopathology.

     

Isolated words enhance statistical language learning in infancy

Infants are adept at tracking statistical regularities to identify word boundaries in pause-free speech. However, researchers have questioned the relevance of statistical learning mechanisms to language acquisition, since previous studies have used simplified artificial languages that ignore the variability of real language input. The experiments reported here embraced a key dimension of variability in infant-directed speech. English-learning infants (8-10 months) listened briefly to natural Italian speech that contained either fluent speech only or a combination of fluent speech and single-word utterances. Listening times revealed successful learning of the statistical properties of target words only when words appeared both in fluent speech and in isolation; brief exposure to fluent speech alone was not sufficient to facilitate detection of the words' statistical properties. This investigation suggests that statistical learning mechanisms actually benefit from variability in utterance length, and provides the first evidence that isolated words and longer utterances act in concert to support infant word segmentation.     

Interactions between statistical and semantic information in infant language development

Infants can use statistical regularities to form rudimentary word categories (e.g. noun, verb), and to learn the meanings common to words from those categories. Using an artificial language methodology, we probed the mechanisms by which two types of statistical cues (distributional and phonological regularities) affect word learning. Because linking distributional cues vs. phonological information to semantics make different computational demands on learners, we also tested whether their use is related to language proficiency. We found that 22-month-old infants with smaller vocabularies generalized using phonological cues; however, infants with larger vocabularies showed the opposite pattern of results, generalizing based on distributional cues. These findings suggest that both phonological and distributional cues marking word categories promote early word learning. Moreover, while correlations between these cues are important to forming word categories, we found infants' weighting of these cues in subsequent word-learning tasks changes over the course of early language development.     

Changing-state disruption of lip-reading by irrelevant sound in perceptual and memory tasks

Three experiments investigated irrelevant sound interference of lip-read lists. In Experiment 1, an acoustically changing sequence of nine irrelevant utterances was more disruptive to spoken immediate identification of lists of nine lip-read digits than nine repetitions of the same utterances (the changing-state effect; Jones, Madden, & Miles, 1992). Experiment 2 replicated this finding when lip-read items were sampled with replacement from the nine digits to form the lip-read lists. In Experiment 3, when the irrelevant sound was confined to the retention interval of a delayed recall task, a changing-state pattern of disruption also occurred. Results confirm a changing-state effect in memory for lip-read items but also point to the possibility that, for lip-reading, changing-state effects may occur at an earlier, perceptual stage.     

Simple rules for detecting depression

Depressive disorders are major public health issues worldwide. We tested the capacity of a simple lexicographic and noncompensatory fast and frugal tree (FFT) and a simple compensatory unit-weight model to detect depressed mood relative to a complex compensatory logistic regression and a naïve maximization model. The FFT and the two compensatory models were fitted to the Beck Depression Inventory (BDI) score of a representative sample of 1382 young women and cross validated on the women's BDI score approximately 18 months later. Although the FFT on average inspected only approximately one cue, it outperformed the naïve maximization model and performed comparably to the compensatory models. The heavier false alarms were weighted relative to misses, the better the FFT and the unit-weight model performed. We conclude that simple decision tools—which have received relatively little attention in mental health settings so far—might offer a competitive alternative to complex weighted assessment models in this domain.     

Effects of response sets on NEO-PI-R scores and their relations to external criteria

Validity scales indicate the extent to which the results of a self-report inventory are a valid indicator of the test taker's psychological functioning. Validity scales generally are designed to detect the common response sets of positive impression management (underreporting, or faking good), negative impression management (overreporting, or faking bad), and random responding. The revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992b) is a popular personality assessment tool based on the 5-factor model of personality and is used in a variety of settings. The NEO-PI-R does not include objective validity scales to screen for positive or negative impression management. The purpose of this study was to examine the utility of recently proposed validity scales for detecting these response sets on the NEO-PI-R (Schinka, Kinder, & Kremer, 1997) and to examine the effects of positive and negative impression management on correlations between the NEO-PI-R and external criteria (the Interpersonal Adjective Scale-Revised-B5 [Wiggins & Trapnell, 1997] and the NEO-PI-R Form R). The validity scales discriminated with reasonable accuracy between standard responding and the 2 response sets. Additionally, most correlations between the NEO-PI-R and external criteria were significantly lower when participants were dissimulating than when responding to standard instructions. It appears that response sets of positive and negative impression management may pose a significant threat to the external validity of the NEO-PI-R and that validity scales for their detection might be a useful addition to the inventory.     

An asymmetric test of homogeneity of proportions

An asymmetrical test of homogeneity of proportions possesses distinct advantages over a symmetrical test. The symmetric chi square test of homogeneity is widely employed in psychological research. An asymmetrical alternative to the chi square test of homogeneity is proposed and described.