Humanizing Personhood

This paper explores the debate between personists, who argue that the concept of a person if of central importance for moral thought, and personists, who argue that the concept of a human being is of greater moral significance. On the one hand, it argues that normative naturalism, the most ambitious defense of the humanist position, fails to identify moral standards with standards of human behavior and thereby fails to undermine the moral significance of personhood. At the same time, it contends that a more focused attention on the morally relevant features of human life may indeed play a crucial role in enhancing our moral understanding.     

Development of a Cognitive-Behavioral Intervention Program to Treat Anxiety and Social Deficits in Teens with High-Functioning Autism

Anxiety is a common co-occurring problem among young people with autism spectrum disorders (ASD). Characterized by deficits in social interaction, communication problems, and stereotyped behavior and restricted interests, this group of disorders is more prevalent than previously realized. When present, anxiety may compound the social deficits of young people with ASD. Given the additional disability and common co-occurrence of anxiety in ASD, we developed a manual-based cognitive-behavioral treatment program to target anxiety symptoms as well as social skill deficits in adolescents with ASD [Multimodal Anxiety and Social Skills Intervention: MASSI]. In this paper, we describe the foundation, content, and development of MASSI. We also summarize data on treatment feasibility based on a pilot study that implemented the intervention.     

Suicide schemas in non-affective psychosis: An empirical investigation

Suicide is the leading cause of premature death among individuals experiencing psychosis. The risk of suicide is proposed to increase with a greater potential for activation of suicide related schemas. Empirical representations of suicide schemas were compared between individuals experiencing non-affective psychosis, with and without a history of suicidal behaviour. Employing a cross-sectional between-groups comparison design, 84 participants, previously diagnosed with a non-affective psychotic disorder, were recruited from community mental health services. Participants completed a demographic questionnaire and clinical measures of psychopathology. To assess participants’ suicide schemas, a series of direct and indirect cognitive tasks were designed and administered. Pathfinder analysis enabled the construction of empirically derived representations of the groups’ suicide schemas based on responses to the cognitive tasks. The suicide group achieved significantly greater scores on measures of anxiety, depression, hopelessness and suicidality than the non-suicide group, but not on measures indicative of the severity of psychosis. The suicide schema for the suicide group was more elaborate and extensive than for the non-suicide group, even when clinical measures were taken into account. Clinical and theoretical implications are discussed.     

Cognitive-behavioral therapy of insomnia: A clinical case series study of patients with co-morbid disorders and using hypnotic medications

Cognitive-behavioral therapy for insomnia (CBTi) has demonstrated considerable efficacy within randomized clinical trials and case-series designs. This case-series study in a community sleep medicine clinic assessed the effectiveness of an eight-session CBTi protocol chronic insomnia patients who were allowed to continue their use of hypnotics (intent-to-treat n = 48), administered by a clinical psychology doctoral student receiving training and supervision in CBTi by a behavioral sleep medicine certified clinician. Outcome measures included daily sleep diaries, self-report measures on insomnia severity, dysfunctional beliefs and attitudes about sleep, daytime sleepiness, as well as medication usage. Patients showed significant improvements in sleep onset latency, wake time after sleep onset, sleep efficiency, insomnia severity, and dysfunctional sleep beliefs from pre- to post-treatment. No changes were seen in daytime sleepiness - patients were not excessively sleepy either before or after treatment. Use of sleep medication declined significantly from 87.5% pre-treatment to 54% post-treatment, despite no active efforts to encourage patients to withdraw. Results demonstrate that a CBTi conducted in a community sleep medicine clinic with patients not required to discontinue sleep-related medications can have similar effects as therapy delivered among those not on medication.     

Perception through a perspective-taking lens: Differential effects on judgment and behavior

In contrast to the view that social perception has symmetric effects on judgments and behavior, the current research explored whether perspective-taking leads stereotypes to differentially affect judgments and behavior. Across three studies, perspective-takers consistently used stereotypes more in their own behavior while simultaneously using them less in their judgments of others. After writing about an African-American, perspective-taking tendencies were positively correlated with aggressive behavior but negatively correlated with judging others as aggressive. Similarly, after writing about an elderly man, perspective-takers walked more slowly and became more conservative, but judged others as less dependent. These divergent effects of perspective-taking on judgment and behavior occurred regardless of whether perspective-taking was manipulated or measured, whether judgments were measured before or after behavior, the stereotype that was activated, and participants’ culture (American, Singaporean). These findings support theorizing that judgments and behavior can diverge when individuals’ social strategies are geared towards establishing and maintaining social bonds, as well as provide insight into how perspective-taking helps individuals manage diversity.     

The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder

This study explored the impact of disruptive behavior disorder (DBD) comorbidity on a number of theoretically relevant outcomes among 192 children and adolescents with obsessive-compulsive disorder (OCD). Youth were divided into three groups: OCD Only, OCD+DBD comorbidity and OCD+Other comorbidity. Relative to those without a comorbid condition and those with any non-DBD comorbidity, comorbid DBD was associated with greater family accommodation and less symptom resistance. Youth with comorbid DBD exhibited greater OCD symptom severity, OCD-related impairment, anxiety, and internalizing problems than those with no comorbidity. Those with comorbid DBD were over 3.6 times as likely to be taking an atypical antipsychotic medication relative to children without comorbidity. The present results suggest that comorbid DBD contributes to more severe illness presentation above and beyond an OCD diagnosis alone, and may be associated with differing pharmacotherapy prescribing practices.     

A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

Disqualified and qualified poor sleepers: subjective and objective variables

Sleep laboratory studies of patients complaining of insomnia have demonstrated discrepancies between subjective reports and electroencephalograph (EEG)-recorded measures. In our research studies on sleeping aids, 60% of the self-described poor sleepers who reported usual sleep latencies of at least 45 min did not meet the laboratory qualification criterion of a 30-min or longer sleep latency. To learn to predict who would qualify for our studies, we compared 30 laboratory-qualified poor sleepers (QPS) with 30 laboratory-disqualified poor sleepers (DPSs) on subjective report, mood, and all-night sleep laboratory variables. QPSs had significantly lower sleep efficiency and total sleep time in the laboratory, but these differences were due to the longer sleep latencies (50.7 +/- 27.8 min vs. 15.2 +/- 6.1 min) of the QPS group. QPSs and DPSs differed significantly in their morning estimates of their laboratory sleep latencies; as a group, QPSs gave an accurate estimate (51.6 +/- 27.8 min), but DPSs were significantly more likely to exaggerate their sleep latencies. Although we did not identify ways of predicting which poor sleepers would show sleep-onset insomnia in the sleep laboratory, we did find that, in this young, healthy population, there are poor sleepers who give an accurate report of a rather severe sleep-onset insomnia.     

Psychometric Properties of the Anticipatory Social Behaviours Questionnaire

Relative to other components of Clark and Wells’ (1995) model, anticipatory processing has been understudied, despite research that suggests that anticipatory processing may maintain social anxiety through mechanisms such as increased anxiety, negative memory biases, and other negative consequences. Anticipatory processing has only been examined as a unitary process, with no efforts examining the underlying structure of this process. The purpose of the current study was to examine the factor structure of the Anticipatory Social Behaviours Questionnaire (ASBQ, Hinrichsen and Clark Journal of Behavior Therapy and Experimental Psychiatry, 34, 205–218, 2003) and identify relationships between the measure’s factors and other constructs of social anxiety. Study 1 (N?=?861) used exploratory factor analysis and concluded that a two-factor model (Avoidance and Preparation) was the best conceptualization of anticipatory processing. Study 2 confirmed the two factor model in a separate sample (N?=?485) and demonstrated the superiority of the two-factor model over a unitary model. Results of Study 3 suggested that, with a sample of high-socially-anxious undergraduates (N?=?59), the Avoidance factor was more maladaptive than the Preparation factor. Results are discussed in the context of the anticipatory processing literature and future directions are proposed.     

Does response mode affect amount recalled or the magnitude of the testing effect?

The testing effect is the finding that retrieval practice can enhance recall on future tests. One unanswered question is whether first-test response mode (writing or speaking the answer) affects final-test performance (and whether final-test response mode itself matters). An additional unsettled issue is whether written and oral recall lead to differences in the amount recalled. In three experiments, we examined these issues: whether subjects can recall more via typing or speaking; whether typing or speaking answers on a first test can lead to better final-test performance (and whether an interaction occurs with final-test response mode) and whether any form of overt response leads to better final-test performance as compared to covert retrieval (thinking of the answer but not producing it). Subjects studied paired associates; took a first test by typing, speaking, or thinking about responses; and then took a second test in which the answers were either spoken or typed. The results revealed few differences between typing and speaking during recall, and no difference in the size of the testing effect on the second test. Furthermore, an initial covert retrieval yielded roughly the same benefit to future test performance as did overt retrieval. Thus, the testing effect was quite robust across these manipulations. The practical implication for learning is that covert retrieval provides as much benefit to later retention as does overt retrieval and that both can be effective study strategies.