Empirically and clinically useful decision making in psychotherapy: differential predictions with treatment response models

In the delivery of clinical services, outcomes monitoring (i.e., repeated assessments of a patient's response to treatment) can be used to support clinical decision making (i.e., recurrent revisions of outcome expectations on the basis of that response). Outcomes monitoring can be particularly useful in the context of established practice research networks. This article presents a strategy to disaggregate patients into homogeneous subgroups to generate optimal expected treatment response profiles, which can be used to predict and track the progress of patients in different treatment modalities. The study was based on data from 618 diagnostically diverse patients treated with either a cognitive-behavioral treatment protocol (n = 262) or an integrative cognitive-behavioral and interpersonal treatment protocol (n = 356). The validity of expected treatment response models to predict treatment in those 2 protocols for individual patients was evaluated. The ways such a procedure might be used in outpatient centers to learn more about patients, predict treatment response, and improve clinical practice are discussed.     

Unconscious manipulation of free choice in humans

Previous research has shown that subliminally presented stimuli accelerate or delay responses afforded by supraliminally presented stimuli. Our experiments extend these findings by showing that unconscious stimuli even affect free choices between responses. Thus, actions that are phenomenally experienced as freely chosen are influenced without the actor becoming aware of the manipulation. However, the unconscious influence is limited to a response bias, as participants chose the primed response only in up to 60% of the trials. LRP data in free choice trials indicate that the prime was not ineffective in trials in which participants chose the non-primed response as then it delayed performance of the incongruently primed response.     

A personal construct psychology view of relapse: indications for a narrative therapy component to stuttering treatment

Relapse following treatment for stuttering is a common problem for many clients. It has often been suggested that one factor contributing to relapse is the client's difficulty in adjusting to a new role as a fluent speaker. In this tutorial article, we first present a personal construct view of relapse, which suggests that this difficulty may be addressed by increasing the meaningfulness of the fluent speaker role for the speaker. Section 3 proposes that post-treatment success for persons who stutter may be facilitated by the use of a narrative approach to counseling in which the meaningfulness of the fluent speaker role is elaborated. In this approach, clients are guided through a process of deconstructing their stuttering-dominated personal narrative, followed by the reconstruction of an alternative narrative that is more compatible with being a fluent speaker. EDUCATIONAL OBJECTIVES: The reader will (1) learn about a personal construct psychology perspective on resistance and relapse in stuttering therapy, (2) be able to describe a narrative approach to counseling for people who stutter that is directed toward the long-term maintenance of fluent speech and the steps of deconstruction of the dominant stuttering narrative and reconstruction of a new, more fluent personal narrative, and (3) be able to prepare a series of narrative interview questions with which to engage clients in conversations that may facilitate the deconstruction and reconstruction processes.     

Comparing continuous and dichotomous scoring of the balanced inventory of desirable responding

The Balanced Inventory of Desirable Responding (BIDR; Paulhus, 1994) is a widely used instrument to measure the 2 components of social desirability: self-deceptive enhancement and impression management. With respect to scoring of the BIDR, Paulhus (1994) authorized 2 methods, namely continuous scoring (all answers on the continuous answer scale are counted) and dichotomous scoring (only extreme answers are counted). In this article, we report 3 studies with student samples, and continuous and dichotomous scoring of BIDR subscales are compared with respect to reliability, convergent validity, sensitivity to instructional variations, and correlations with personality. Across studies, the scores from continuous scoring (continuous scores) showed higher Cronbach's alphas than those from dichotomous scoring (dichotomous scores). Moreover, continuous scores showed higher convergent correlations with other measures of social desirability and more consistent effects with self-presentation instructions (fake-good vs. fake-bad instructions). Finally, continuous self-deceptive enhancement scores showed higher correlations with those traits of the Five-factor model for which substantial correlations were expected (i.e., Neuroticism, Extraversion, and Conscientiousness). Consequently, these findings indicate that continuous scoring may be preferable to dichotomous scoring when assessing socially desirable responding with the BIDR.     

Effect of personality dimensions on the diurnal pattern of motor activity

The effects of personality dimensions, age, and gender on 24-hour motor activity patterns were studied in 101 healthy subjects between 20-70 years. We measured motor activity by wrist-actigraphy and personality dimensions by the Tridimensional Personality Questionnaire (TPQ) of Cloninger. Random Regression Models were used to estimate the effects of personality dimensions, age, and gender on the diurnal pattern of motor activity. Harm Avoidance as well as Reward Dependence influenced the overall level of motor activity, independent of age and gender. Subjects high on Harm Avoidance showed lower activity levels than subjects low on Harm Avoidance, whereas subjects high on Reward Dependence had higher overall levels of motor activity than subjects low on Reward Dependence. Older subjects were found to be less active than younger subjects, but the activity level did not differ between males and females.     

Evaluating the AWARE Inventory as a measure of relationship factors among a sample of high school students

The Awareness of Attitudes and Relationship Expectations (AWARE) Inventory was administered to 160 high school students in Wyoming. Factor analysis showed the inventory did not have the expected 11 dimensional factor structure. Most of the intended 10-item scales yielded unacceptably low estimates of internal consistency reliability. Through an iterative process, one internally consistent scale of 17 items (alpha = .80) was derived. Researchers should be careful to evaluate the AWARE Inventory with their own samples before proceeding under an assumption that its scales reliably assess the 11 dimensions expected.     

Attentional mechanisms linking rejection to hostile reactivity: the role of "hot" versus "cool" focus

Drawing on the hot–cool systems analysis of self–regulation, we examined whether attentional focus mediates the negativity of cognitive–affective reactions to interpersonal rejection. The hypothesis was that whereas a hot, arousing focus to representing rejection experiences should increase anger–hostility, accessing the cool system through distraction and distancing should attenuate such responses. Participants imagined an autobiographical rejection experience, focusing either on their physiological and emotional reactions (hot focus) or on the physical setting of the experience (cool focus). Participants in a third condition received no specific attentional instructions. Both implicit and explicit measures showed that hostile thoughts and feelings were attenuated in the cool–focus compared with the hot–focus condition. The findings support the adaptive value of activating a cooling strategy under hot, arousing conditions that otherwise elicit automatic, hot–system responses.     

Categorizing a moving target in terms of its speed,direction, or both

Pigeons categorized a moving target in terms of its speed and direction in an adaptation of the randomization procedure used to study human categorization behavior (Ashby & Maddox, 1998). The target moved according to vectors that were sampled with equal probabilities from two slightly overlapping bivariate normal distributions with the dimensions of speed and direction. On the average, pigeons categorized optimally in that they attended to either speed or direction alone, or divided attention between them, as was required by different reinforcement contingencies. Decision bounds were estimated for individual pigeons for each attentional task. Average slopes and y intercepts of these individually estimated decision bounds closely approximated the corresponding values for optimal decision bounds. There is therefore at least one task in which pigeons, on the average, display flexibility and quantitative precision in allocating attention to speed and direction when they categorize moving targets.