Parents' perceptions of pharmacological and cognitive-behavioral treatments for childhood anxiety disorders

Cognitive-behavioral therapy (CBT) and pharmacotherapy are the most well-established treatments for childhood anxiety disorders. This study examined how parents (N=71) seeking treatment for their child's anxiety disorder perceive the acceptability, believability, and effectiveness of these treatments. While both treatments were perceived favorably, CBT was rated as more acceptable, believable, and effective in the short- and long-term. Children's treatment history influenced parents' perceptions of pharmacotherapy, with parents of children with no treatment history perceiving medication treatment as less acceptable and believable than parents of children with a history of medication alone or in combination with behavior therapy. No effect of treatment history was found for perceptions of CBT. Significant positive correlations emerged between parents' perceived acceptance and believability for pharmacotherapy and child age and level of dysfunction due to their child's anxiety, respectively. The level of the child's anxiety was not significantly correlated with parents' perceptions of either CBT or pharmacotherapy. Our results suggest that parents of anxious children prefer CBT to medication for the treatment of their child's anxiety disorder. Directions for future research are discussed.     

Recurrent binge eating with and without the "undue influence of weight or shape on self-evaluation": implications for the diagnosis of binge eating disorder

Levels of eating disorder psychopathology, impairment in psycho-social functioning and use of health services were compared among probable cases of binge eating disorder (BED) with and without extreme weight or shape concerns ("undue influence of weight or shape on self-evaluation") recruited from a large community sample of women. Data for obese non-binge eaters (n=457), also recruited from the community sample, and for a clinical sample of eating disorder patients (n=128), recruited separately, were included for comparative purposes. BED cases who reported extreme weight or shape concerns (n=51, 46.4%) had significantly higher levels of eating disorder psychopathology and functional impairment than those who did not report such concerns (n=59), after controlling for between-group differences in age and body weight. In addition, BED cases who reported extreme weight or shape concerns were more likely to have sought treatment for an eating or weight problem than those who did not. Whereas levels of eating disorder psychopathology and functional impairment were markedly elevated among BED cases with extreme weight or shape concerns, BED cases who did not report extreme weight or shape concerns resembled obese non-binge eaters in most respects. The findings support the inclusion of an undue influence of weight or shape on self-evaluation as a diagnostic criterion for BED. In the absence of this influence, eating disorders that otherwise resemble BED do not appear to be "clinically significant".     

Interpretation biases in social anxiety: response generation, response selection, and self-appraisals

Cognitive theories propose that the resolution of ambiguity is related to the maintenance of social anxiety. A sentence completion task was used to examine how individuals high (n=26) and low (n=23) in social anxiety resolve ambiguous social sentences. Individuals were asked to generate as many responses as came to mind for each sentence, and then to endorse the response that best completes the sentence. Total responses, first responses, and endorsed responses were examined separately. Results indicated that high anxious individuals had more negative and anxious responses and fewer positive and neutral responses than low anxious individuals on all sentence completion measures. In contrast, a self-report measure of interpretation bias indicated that more of negative and anxious appraisals were related to social anxiety, while positive and neutral appraisals were not. Results are discussed in terms of a multi-stage processing model of interpretation biases.     

Day-to-day body-image states: prospective predictors of intra-individual level and variability

Most body-image research has focused on the trait level of body-image evaluation, often neglecting the momentary fluctuations many people experience in everyday life. The present prospective study investigated whether theory-relevant body-image measures, perfectionistic self-presentation, and eating attitudes would predict average day-to-day body-image levels and their intra-individual variability. A convenience sample consisted of 121 women from two universities. In Phase 1 of the study, participants completed an online battery of selected body-image and personality questionnaires. In Phase 2, participants went online to complete the dependent measure, the Body Image States Scale, once per evening over 10 days. As hypothesized, more favorable body-image state levels were associated with less investment in appearance for self-worth, less body-image disturbance, fewer body-image cognitive distortions, less disturbed eating attitudes, and lower body mass. Moreover, greater day-to-day body-image variability was predicted by greater psychological investment in appearance, more body-image cognitive distortions, and higher perfectionistic self-presentation. Implications and future directions for research are discussed.     

Ambiguity and rationality

Recently, several theories of decision making and probability judgment have been proposed that take into account ambiguity (Einhorn and Hogarth, 1985; Gardenfors and Sahlin, 1982). However, none of these theories explains exactly what the psychological causes of ambiguity are or addresses the issue of whether ambiguity effects are rational. In this paper, we define ambiguity as the subjective experience of missing information relevant to a prediction. We show how this definition can explain why ambiguity affects decisions in the ways it does. We argue that there are a variety of rational reasons ambiguity affects probability judgments and choices in the ways it does. However, we argue that the ambiguity effect does not cast doubt on the claim that utility theory is a standard of rational choice. Rather, we suggest that the effect of ambiguity on decisions highlights the fact that utility theory, like any normative model of decision making only prescribes the optimal decision, given what one knows.     

Iffy beliefs: Conditional thinking and belief change

The ability to entertain possibilities and draw inferences about them is essential to human intelligence. We examine the hypothesis that conditional if-then statements trigger a mental simulation process in which people suppose the antecedent (if statement) to be true and evaluate the consequent (then statement) in that context. On the assumption that supposing an event to be true increases belief that the event has occurred or will occur, this hypothesis is consistent with the claim that evaluating a conditional will heighten belief in its antecedent more than in its consequent. Two experiments, employing conditionals of the form If animal A has property X, then animal B will have property X, in which X was a property that people could not readily relate to the animals, supported this claim. The effect was stronger following the evaluation of conditionals with dissimilar animal categories.     

Theism, Blame And Perfection

Blame and also punishment do not reach many agents in the sense that many agents are not motivated to ethically self-correct, and in fact, may be worsened by these practices. The main reasons agents may not be reached by them are that (on the most plausible secular or naturalistic ethical theory) (a) the agent's second nature may make inaccessible to him a sound appreciation of ethical considerations, and (b) the fixity of mature character may make ethical self-correction practically impossible. Still, when they are ethically rationalized, blame and punishment seem to be requirements. Even the most plausible secular or naturalistic ethics involves an important kind of incompleteness and unclarity concerning this issue. The Jewish and Christian traditions involve conceptions of the accessibility of ethical considerations and also the possibility of character change (both ultimately grounded in grace) in ways that enable us to overcome the perplexity about blame and punishment. They are not 'good for nothing' even when they fail to improve agents. The religious traditions' conceptions of moral agency and the possibility of perfection enable us to see why there are reasons not to ethically 'write off' even persistently vicious agents. Moreover, we can see that the fulfilling of ethical requirements is an enabling condition for perfection that is not merely ethical. To highlight the contrast between the naturalistic view and the theistic view, Aristotle's moral psychology and moral epistemology are contrasted with those of Maimonides and Aquinas, both of whom borrow heavily from Aristotle, but fundamentally transform what they borrow.     

Technical expertise and the construction of the rural Yishuv, 1882–1948

In fin de sièecle Europe, political economy viewed science as an indispensable tool of state power. Accordingly, in the early 1900s exponents of Zionist political economy saw the World Zionist Organization (WZO) as a government with the responsibility to direct the nation-building enterprise in Palestine. The principle beneficiaries of assistance from the WZO, youthful pioneer laborers from eastern Europe,shared the WZO's reverence for technical knowledge, but distrusted technicians, whom they associated with authoritarianism. In the eyes of the pioneer laborers, a technican should not lead, but rather make vital resources available to the workers to use as they saw fit. Key figures in the WZO's settlement institutions accepted this subordinate status for the technician and employed technical experts to guide,rather than direct, the labor movement in the construction of publicly-funded, co-operative agricultural settlements. From its beginning, however, the Zionist movement featured an alternative conception of technical expertise, drawn more from business economics than political economy, and tending to favor as its model the corporation rather than the state. One characteristic of this approach was the conviction that apolitical experts should direct settlement activity.For a brief period during the 1920s, champions of this approach wielded influence over the WZO's settlement institutions. But as a result of the tumultuous events of the years 1929–1939, the Zionist settlement enterprise fused politics and economics tightly together. From the mid-1930s on to the founding of the state of Israel, technical expertise was mobilized to serve the political and military leadership of the Yishuv. This revised version was published online in August 2006 with corrections to the Cover Date.