Psychometric Properties of an Italian Version of the Differentiation of Self Inventory-Revised (It-DSI-R)

The Differentiation of Self (DoS) is a key concept of Bowen’s theory, indicating a process that begins in early infancy and progresses throughout childhood and adolescence, to reach a basic level in early adulthood. This study examined the psychometric properties of an Italian version of the Differentiation of Self Inventory-Revised (DSI-R) Skowron, Schmitt, Journal of Marital and Family Therapy 29:209–222, 2003), a multidimensional measure assessing DoS as conceptualized by Bowen. The sample comprised 671 subjects (age 19–69 year). Exploratory and confirmatory factor analyses showed that the Italian DSI-R possesses good psychometric properties. Internal consistencies were adequate. Correlations with the Dyadic Adjustment Scale, the Symptom Checklist 90-Revised, and the trait form of the State-Trait Anxiety Inventory were consistent with the theoretical relations among the constructs. The findings confirm the use of DSI-R as a psychometrically sound measure of the differentiation of self in the Italian context. Implications for future research and clinical practice are addressed.     

A Case Study of Individually Delivered Mindfulness-Based Cognitive Behavioral Therapy for Severe Health Anxiety

Health anxiety involves persistent worry about one's physical health, despite medical reassurance. Cognitive-behavioral therapy (CBT) is currently the most widely used, evidence-based treatment for health anxiety. Mindfulness-based cognitive therapy (MBCT) is an evidence-based cognitive-behavioral treatment approach that may be useful for health anxiety due to its focus on nonjudgmental awareness and acceptance of physical and emotional events. MBCT has largely been evaluated in a group format; however, the majority of outpatient CBT providers rely also on individual treatments. No research to date has examined the utility of MBCT delivered as an individual therapy for patients with health anxiety. The purpose of the current case study is to describe the delivery, acceptability, and effects of an individually delivered mindfulness-based cognitive-behavioral intervention on health anxiety symptoms for a young woman with severe health anxiety referred to outpatient behavioral medicine by her primary care provider. The treatment was a 16-session, patient-centered intervention largely delivered using MBCT techniques, supplemented by traditional cognitive-behavioral techniques. The patient completed a validated self-report measure of health anxiety symptoms (SHAI) at the beginning of each session. The treatment was found to be acceptable, as evidenced by high treatment attendance and patient feedback. The patient reported significant cognitive, affective, and behavioral improvements, including a 67% reduction in medial visits. Health anxiety scores on the SHAI showed a 52% decrease from the first to last session, reliable change index score of 12.11, and fell below the clinical cutoff at the final session, demonstrating clinical significance. These results suggest that it is feasible to adapt MBCT for the individual treatment of health anxiety, and that controlled trials of individual MBCT are warranted.     

Decision-making quality of younger and older adults in familiar and unfamiliar domains

Age-related differences in purchasing decisions were examined as a function of age and familiarity. On each trial, participants received purchasing options which varied in quality but ultimately cost the same amount of money. On half the trials, participants made decisions about items familiar to younger adults and on the other half of the trials, participants made decisions about products familiar to older adults. The participants’ task was to choose the option that provided the best value for the money. We were particularly interested in participants’ performance when inferencing was required to select the optimal option from the two choices. Younger adults outperformed older adults in unfamiliar but not familiar domains. It appeared that both younger and older adults used inferencing and elaborative processing to make the best decision in familiar domains but that only younger adults used inferencing and elaborative processing in unfamiliar domains.     

Physician Migration: Experience of International Medical Graduates in the USA

The purpose of this study was to explore the experience of foreign-born international medical graduates (IMGs) in the USA. Few studies describe IMG experiences in attaining medical licensure in the USA at each step of the process. Furthermore, little is known about IMGs who choose not to become a licensed physician or were unsuccessful in doing so. In this study, 20 foreign-born IMGs, 16 practicing IMGs and 4 non-licensed physician IMGs, participated in a 1-h semi-structured face-to-face interview between September 2013 and April 2014. Participants were from North America (Canada), Latin America, South Asia, East Asia, Europe, the Middle East, or Sub-Saharan Africa. Interviews were transcribed. Two of the authors conducted initial analysis of each interview separately. Four primary themes emerged based on the data analysis: (1) barriers to physician careers include the immigration process, years since graduating from medical school, language and culture, and cost and time; (2) positive factors to support physician careers include networking and research experience; (3) factors that positively or negatively affect IMGs seeking physician careers such as the education system in a home country and family; and (4) non-physician careers. In order to develop multiple pathways to utilize IMGs in the US healthcare system, future research examining the following areas is necessary: (1) support systems for IMGs who are taking the US Medical Licensing Exam (USMLE) or applying for a residency position and (2) the experience of IMGs who are not certified physicians in the USA.     

Communication Via Instant Messenger: Short- and Long-Term Effects

Ersatz social engagement theory (Green & Brock, 1998, 2003) suggests that individuals may be drawn to mediated interactions because of their ease, lack of risk, and immediate gratification, but that these interactions may be less rewarding over the long term. In Study 1 ( N = 42), participants' moods were measured before and after engaging in a conversation with a stranger either online (instant messenger) or face to face. Participants became slightly less tense and less angry regardless of which condition they were in, but significantly happier when they were in the instant messenger (1M) condition. The increased happiness after an IM rather than face-to-face conversation was especially pronounced among women. Study 2 ( N = 101) was a survey of students' Internet use and other extracurricular activities. Students did not appear to be substituting Internet use for other forms of extracurricular engagement. However, IM use was associated with feeling that one used the Internet too much, and reduced life satisfaction.     

Convergence between measures of work-to-family and family-to-work conflict: A meta-analytic examination

The overlap between measures of work-to-family (WFC) and family-to-work conflict (FWC) was meta-analytically investigated. Researchers have assumed WFC and FWC to be distinct, however, this assumption requires empirical verification. Across 25 independent samples (total N = 9079) the sample size weighted mean observed correlation was .38 and the reliability corrected correlation was .48. The pattern of external correlates for the two types of conflict was also examined. Both forms of conflict had similar (.41) reliability corrected correlations with measures of organizational withdrawal. WFC conflict correlated .41 (k =  15, N = 4714) with job stressors and .17 (k = 13, N = 3312) with non-work stressors whereas FWC conflict correlated .27 with job stressors and .23 with non-work stressors. Correlations between the two forms of work/family conflict and other variables such as organizational commitment, job and life satisfaction, and health were examined. Implications for the discriminant validity of the two types of conflict measures are discussed.     

Cognitive and developmental influences in visual-motor integration skills in young children

Measures of visual-motor integration skills continue to be widely used in psychological assessments with children. However, the construct validity of many visual-motor integration measures remains unclear. In this study, we investigated the relative contributions of maturation and cognitive skills to the development of visual-motor integration skills in young children (N = 856). We used a block regression analysis to determine the contribution of maturation, as indicated by age, followed by broad cognitive factors (Study 1) and subsequently by individual subtests in verbal and nonverbal domains subsumed under each factor (Study 2) in explaining score variance of the Bender Visual-Motor Gestalt Test (2nd ed.; BG-II; Brannigan & Decker, 2003) Copy and Recall scores in children between the ages of 4 and 7 years. Results confirm that maturation accounted for a large proportion of variance in both BG-II Copy and Recall performance, above which Stanford-Binet Intelligence Scale (5th ed.; SB-5; Roid, 2003) Quantitative Reasoning and Fluid Reasoning factors significantly contributed to visual-motor integration performance for the Copy phase, and SB-5 Quantitative Reasoning and Visual-Spatial factors accounted for a significant amount of variance for the Recall phase. Additionally, nonverbal domains were more related to visual-motor performance than verbal domains. Results from this study are interpreted to suggest nonverbal reasoning and visual-spatial attention are important contributing factors to visual-motor integration, as measured by the BG-II. Developmental implications of visual-motor integration skills, nonverbal problem solving, and mathematical competence are discussed.     

Efficacy of a Self-Administered Home-Based Parent Intervention on Parenting Behaviors for Preventing Adolescent Substance Use

A growing body of literature suggests that parenting practices characterized by careful monitoring, firm and consistent limit setting, and nurturing communication patterns with children are protective against adolescent substance use and other problem behaviors. Family-based prevention programs that promote these behaviors can be an effective way to prevent adolescent substance use. However, low participation rates remain problematic for many such programs, particularly programs that require parents to attend scheduled meetings outside the home. The purpose of this study was to determine the efficacy of a newly developed substance use prevention program when self-administered at home by parents of middle school students. As part of a randomized trial, 338 parents of middle school students either received the parent prevention program or served as control group participants. Parents completed self-report surveys at home that assessed parenting behaviors at pre-test, post-test, and one-year follow-up time points. A series of mixed model ANCOVAs were conducted, examining the post-test and one-year follow-up means for the parent outcomes, controlling for pre-test levels on these outcomes. Analyses showed that at the post-test assessment, intervention parents reported significant increases relative to controls in appropriate role modeling, disciplinary practices, family communication, and parental monitoring skills. At the one-year follow-up assessment, intervention effects on family communication skills remained significant and effects on parental role modeling were marginally significant. This study shows that a theoretically rich prevention program can be effectively self-administered by parents at home and improve key parenting skills that have been shown to prevent adolescent substance use.     

Eye movements reveal solution knowledge prior to insight

In two experiments, participants solved anagram problems while their eye movements were monitored. Each problem consisted of a circular array of five letters: a scrambled four-letter solution word containing three consonants and one vowel, and an additional randomly-placed distractor consonant. Viewing times on the distractor consonant compared to the solution consonants provided an online measure of knowledge of the solution. Viewing times on the distractor consonant and the solution consonants were indistinguishable early in the trial. In contrast, several seconds prior to the response, viewing times on the distractor consonant decreased in a gradual manner compared to viewing times on the solution consonants. Importantly, this pattern was obtained across both trials in which participants reported the subjective experience of insight and trials in which they did not. These findings are consistent with the availability of partial knowledge of the solution prior to such information being accessible to subjective phenomenal awareness.