The co-constructed therapy alliance and the technical and tactical quality of the therapist interventions in psychotherapy

This study sought to describe a brief review of studies conducted on the therapeutic alliance, taking into consideration therapeutic process and outcomes. We seek to reflect about the need to encourage the communities who engage in and conduct research on clinical practice not only to implement surveys of empirically validated measures of therapeutic outcomes, but also make them a regular practice among all clinical mental health psychotherapists. We therefore suggest the following paradigm – the Practice Based on Evidence of Results (PBER) – as a way to improve the quality of technical and tactical interventions of psychotherapists     

Missed first appointments: Prevalence and associated factors in first-time attendees at an outpatient psychiatric clinic in Nigeria

In Nigeria, outpatient care forms the bulk of the psychiatric service. While there are no published data, empirical observations indicate that default may be high and exerting a huge toll on the cost of care. The aims were to determine the first-appointment default rate among newly seen outpatients in a psychiatric clinic and to identify factors associated with it. The study was a survey of all newly seen patients from 1 January 2006 to 31 January 2006, and who were given a follow-up appointment. A total of 223 new patients were seen. Of these, 151 (67.7%) turned up for their appointment, 61 (27.4%) defaulted, and 11 (4.9%) were referred. Defaulters were more likely to be Christians, younger in age, and in employment. On using correlation statistics, respondents’ religion and occupational status demonstrated a linear relationship and a significant association with follow-up attendance/non-attendance. The rate of non-attendance at first follow-up is of clinical concern, and the possible contribution of religion to this may be enormous. Clinicians and health policy makers need to be sensitive to this. The introduction of community psychiatric services and collaboration between orthodox and traditional/religious practitioners may help reduce default rates.     

Domestic dogs (Canis familiaris) coordinate their actions in a problem-solving task

Cooperative hunting is a cognitively challenging activity since individuals have to coordinate movements with a partner and at the same time react to the prey. Domestic dogs evolved from wolves, who engage in cooperative hunting regularly, but it is not clear whether dogs have kept their cooperative hunting skills. We presented pairs of dogs with a reward behind a fence with two openings in it. A sliding door operated by the experimenter could block one opening but not both simultaneously. The dogs needed to coordinate their actions, so that each was in front of a different opening, if one of them was to cross through and get food. All 24 dog pairs solved the problem. In study 1, we demonstrated that dogs understood how the apparatus worked. In study 2, we found that, although the performance of the pairs did not depend on the divisibility of the reward, pairs were quicker at coordinating their actions when both anticipated rewards. However, the dogs did not monitor one another, suggesting that their solutions were achieved by each individual attempting to maximize for itself.     

Attentional biases and memory for emotional stimuli in men and male rhesus monkeys

We examined attentional biases for social and non-social emotional stimuli in young adult men and compared the results to those of male rhesus monkeys (Macaca mulatta) previously tested in a similar dot-probe task (King et al. in Psychoneuroendocrinology 37(3):396–409, 2012). Recognition memory for these stimuli was also analyzed in each species, using a recognition memory task in humans and a delayed non-matching-to-sample task in monkeys. We found that both humans and monkeys displayed a similar pattern of attentional biases toward threatening facial expressions of conspecifics. The bias was significant in monkeys and of marginal significance in humans. In addition, humans, but not monkeys, exhibited an attentional bias away from negative non-social images. Attentional biases for social and non-social threat differed significantly, with both species showing a pattern of vigilance toward negative social images and avoidance of negative non-social images. Positive stimuli did not elicit significant attentional biases for either species. In humans, emotional content facilitated the recognition of non-social images, but no effect of emotion was found for the recognition of social images. Recognition accuracy was not affected by emotion in monkeys, but response times were faster for negative relative to positive images. Altogether, these results suggest shared mechanisms of social attention in humans and monkeys, with both species showing a pattern of selective attention toward threatening faces of conspecifics. These data are consistent with the view that selective vigilance to social threat is the result of evolutionary constraints. Yet, selective attention to threat was weaker in humans than in monkeys, suggesting that regulatory mechanisms enable non-anxious humans to reduce sensitivity to social threat in this paradigm, likely through enhanced prefrontal control and reduced amygdala activation. In addition, the findings emphasize important differences in attentional biases to social versus non-social threat in both species. Differences in the impact of emotional stimuli on recognition memory between monkeys and humans will require further study, as methodological differences in the recognition tasks may have affected the results.     

Visual discrimination thresholds for time to arrival

In a seminal article, Todd (Journal of Experimental Psychology: Human Perception and Performance 7:795-810, 1981) reported a difference threshold of about 50 ms to discriminate the times of arrival of two differently sized objects that simultaneously approached head-on at constant but different velocities. Subsequent investigators, however, have often found much higher thresholds. We did one complete replication of Todd’s experiment, and then modified his stimuli and experimental regime, which we hypothesized may have been responsible for some of the discrepancies reported in the literature. Unlike Todd and most other researchers, we exclusively used untrained observers. Several of our participants performed almost as well as the trained observers used by Todd and others, but the performance of most of our participants fell short of this standard. Furthermore, thresholds were affected by the experimental regimes, with large differences between objects’ sizes and speeds compromising performance. Analyses of the response patterns revealed that the responses were driven mainly by the objects’ relative apparent sizes.     

Dynamics of facilitation and interference in cue-priming and Simon tasks

In examining the selective suppression of responses activated by task-irrelevant stimulus attributes, such as in spatial conflict tasks, two different approaches have pointed to similar conclusions. In one approach (involving cue-priming procedures), variations of the stimulus-onset asynchrony (SOA) between task-irrelevant cues and subsequent target stimuli disclosed that the cues elicit activation of the congruent response, but this activation is subsequently suppressed. In another approach, a series of studies with the Simon task led to the formulation of the activation-suppression hypothesis. Analysis of RT distributions (in particular delta plots) disclosed that the task-irrelevant stimulus location elicits activation of the spatially corresponding response, but this activation is subsequently suppressed. The strength or efficiency of selective response suppression is expressed in the slope of the delta plot. In the present study, we combined these two approaches and found that the effects of SOA manipulation and the results of the distributional analysis converged and were positively correlated, suggesting that they involve a common mechanism of response activation followed by the selective suppression of that activation.     

Social support,self-esteem and depression: Relationship with risk for sexually transmitted infections/HIV transmission

Sexually transmitted infections (STIs) and HIV are important health problems that affect adolescents. The aim of the present study was to analyze the relationship between 1) depression, self-esteem and perceived social support and 2) sexual risk behaviors according to gender. The sample used in this ex post facto study was composed of 1,005 adolescents of both sexes aged between 14 and 18 years. Participants completed several questionnaires in the classrooms of their secondary education schools. The questionnaires assessed depression, self-esteem and perceived social support and recorded information on sexual behavior and socio-demographic issues. Results showed that, among males, self-esteem predicted higher vaginal risk, depression was related to higher vaginal, anal and oral sexual risk, and perceived support from the family predicted lower vaginal and anal sexual risk. Among females, self-esteem was found to be associated with lower anal sexual risk and perceived support from friends predicted lower anal and oral sexual risk. The study highlights the importance of considering family and friends as well as gender differences in the prevention of STIs/HIV.     

Socio-demographic and psychopathological risk factors in obsessive-compulsive disorder: Epidemiologic study of school population

We assessed the presence of emotional disorders (obsessive-compulsive, anxiety and depressive) in 1,514 Spanish non-referred children (8–12 years old) to investigate the predictive ability of psychopathological and socio-demographic characteristics, and identify which of these were possible correlates for clinical obsessive-compulsive disorder (OCD) and subclinical OCD. At one year later, 562 subjects (risk group and without risk group) were re-assessed and we established the OCD diagnoses or the subclinical OCD diagnoses. We found that 20 participants presented clinical OCD and 46 participants presented subclinical OCD. Somatic and separation anxiety symptomatology were good predictors for clinical OCD, and obsessive concern was a predictor for subclinical OCD. Clinical OCD was associated with order/checking/pollution symptoms and with a lower socioeconomic status (SES). Subclinical OCD was associated with hyperactive and impulsive manifestations, obsessive concern, and superstition/mental compulsion. An early detection and the follow-up of anxiety or obsessive symptoms in children may be important for preventing the course of OCD.