Designs for studying the effectiveness of long-term psychoanalytic treatments: balancing level of evidence and acceptability to patients

Long-Term Psychoanalytic Treatments (LTPT) include both long-term psychoanalytic psychotherapy (LTPP) and psychoanalysis (PsAn). Current opinion seems to be that there is some evidence for the effectiveness of LTPP, but none for that of PsAn. This may be due in part to researchers not balancing the level of evidence of randomized controlled studies (RCTs), cohort studies, and pre-post studies with patients' acceptance of these various research designs used in studying the effectiveness of LTPT. After a review of the merits of eight possible control conditions for LTPT in RCTs and cohort studies, and a consideration of the limitations and merits of pre-post studies, it was found that RCTs pair high levels of evidence with limited degrees of patient acceptance, especially where PsAn is concerned. Cohort studies appear to provide at most a moderate level of evidence. Their acceptability is hardly better than that of RCTs, as it depends on the acceptability of control conditions similar to those of RCTs. The acceptability of pre-post studies is much better, but they can provide, at most, a moderate level of evidence. Apart from randomization, they can meet all methodological criteria for high-quality research (often they do not, but there are ways to correct this). In summary, in the long-term treatment of complex mental disorders with LTPT, RCTs often pair a high level of evidence with limited patient acceptance of the method. Compared to RCTs, cohort studies show a lower level of evidence without much gain in acceptability. Pre-post studies pair the highest level of acceptability with the lowest level of evidence of the three designs. Limited acceptability is not to be confused with no acceptability, nor moderate level of evidence with none.     

Recognition confidence under violated and confirmed memory expectations

Individuals' memory experiences typically covary with those of others' around them, and on average, an item is more likely to be familiar if a companion recommends it as such. Although it would be ideal if observers could use the external recommendations of others' as statistical priors during recognition decisions, it is currently unclear how or if they do so. Furthermore, understanding the sensitivity of recognition judgments to such external cues is critical for understanding memory conformity and eyewitness suggestibility phenomena. To address this we examined recognition accuracy and confidence following cues from an external source (e.g., "Likely Old") that forecast the likely status of upcoming memory probes. Three regularities emerged. First, hit and correct-rejection rates expectedly fell when participants were invalidly versus validly cued. Second, hit confidence was generally higher than correct-rejection confidence, regardless of cue validity. Finally, and most noteworthy, cue validity interacted with judgment confidence such that validity heavily influenced the confidence of correct rejections but had no discernible influence on the confidence of hits. Bootstrap-informed Monte Carlo simulation supported a dual process recognition model under which familiarity and recollection processes counteract to heavily dampen the influence of external cues on average reported confidence. A 3rd experiment tested this model using source memory. As predicted, because source memory is heavily governed by contextual recollection, cue validity again did not affect confidence, although as with recognition it clearly altered accuracy.     

Managing motivational conflict: How self-esteem and executive resources influence self-regulatory responses to risk

This article explores how self-esteem and executive resources interact to determine responses to motivational conflict. One correlational and 3 experimental studies investigated the hypothesis that high and low self-esteem people undertake different self-regulatory strategies in "risky" situations that afford opportunity to pursue competing goals and that carrying out these strategies requires executive resources. When such resources are available, high self-esteem people respond to risk by prioritizing and pursuing approach goals, whereas low self-esteem people prioritize avoidance goals. However, self-esteem does not influence responses to risk when executive resources are impaired. In these studies, risk was operationalized by exposing participants to a relationship threat (Studies 1 and 2), by using participants' self-reported marital conflict (Study 3), and by threatening academic competence (Study 4). Executive resources were operationalized as cognitive load (Studies 1 and 2), working memory capacity (Study 3), and resource depletion (Study 4). When executive resources were ample, high self-esteem people responded to interpersonal risk by making more positive relationship evaluations (Studies 1, 2, and 3) and making more risky social comparisons following a personal failure (Study 4) than did low self-esteem people. Self-esteem did not predict participants' responses when executive resources were impaired or when risk was absent. The regulatory function of self-esteem may be more resource-dependent than has been previously theorized. (PsycINFO Database Record (c) 2012 APA, all rights reserved).     

Reducing developmental risk for emotional/behavioral problems: a randomized controlled trial examining the Tools for Getting Along curriculum

Researchers have demonstrated that cognitive-behavioral intervention strategies - such as social problem solving - provided in school settings can help ameliorate the developmental risk for emotional and behavioral difficulties. In this study, we report the results of a randomized controlled trial of Tools for Getting Along (TFGA), a social problem-solving universally delivered curriculum designed to reduce the developmental risk for serious emotional or behavioral problems among upper elementary grade students. We analyzed pre-intervention and post-intervention teacher-report and student self-report data from 14 schools, 87 classrooms, and a total of 1296 students using multilevel modeling. Results (effect sizes calculated using Hedges' g) indicated that students who were taught TFGA had a more positive approach to problem solving (g=.11) and a more rational problem-solving style (g=.16). Treated students with relatively poor baseline scores benefited from TFGA on (a) problem-solving knowledge (g=1.54); (b) teacher-rated executive functioning (g=.35 for Behavior Regulation and .32 for Metacognition), and proactive aggression (g=.20); and (c) self-reported trait anger (g=.17) and anger expression (g=.21). Thus, TFGA may reduce risk for emotional and behavioral difficulties by improving students' cognitive and emotional self-regulation and increasing their pro-social choices.     

Reallocating attention during multiple object tracking

Wolfe, Place, and Horowitz (Psychonomic Bulletin & Review 14:344?C349, 2007) found that participants were relatively unaffected by selecting and deselecting targets while performing a multiple object tracking task, such that maintaining tracking was possible for longer durations than the few seconds typically studied. Though this result was generally consistent with other findings on tracking duration (Franconeri, Jonathon, & Scimeca Psychological Science 21:920?C925, 2010), it was inconsistent with research involving cuing paradigms, specifically precues (Pylyshyn & Annan Spatial Vision 19:485?C504, 2006). In the present research, we broke down the addition and removal of targets into separate conditions and incorporated a simple performance model to evaluate the costs associated with the selection and deselection of moving targets. Across three experiments, we demonstrated evidence against a cost being associated with any shift in attention, but rather that varying the type of cue used for target deselection produces no additional cost to performance and that hysteresis effects are not induced by a reduction in tracking load.     

Linguistic correlates of social anxiety disorder

The goal of this study was to examine the linguistic correlates of social anxiety disorder (SAD). Twenty-four individuals with SAD (8 of them with a generalised subtype) and 21 non-anxious controls were asked to give speeches in front of an audience. The transcribed speeches were examined for the frequency of negations, I-statements, we-statements, negative emotion words, and positive emotion words. During their speech, individuals with either SAD subtype used positive emotion words more often than controls. No significant differences were observed in the other linguistic categories. These results are discussed in the context of evolutionary and cognitive perspectives of SAD.     

Can fluency be interpreted as novelty? Retraining the interpretation of fluency in recognition memory

Stimuli that are processed fluently tend to be regarded as more familiar and are more likely to be classified as old on a recognition test compared with less fluent stimuli. Recently it was shown that the standard relationship between fluency and positive recognition judgments can be reversed if participants are trained that previously studied stimuli are associated with lower levels of fluency. Under such conditions, fluent stimuli are more likely to be classified as new on a recognition test (C. Unkelbach, 2006), which suggests that the interpretation of fluency is malleable and context dependent. Five experiments investigated the resilience of this reversed fluency effect. Using 2 different fluency manipulations, the finding of a reversed fluency effect after training was replicated. However, it was also found that the reversal depends on explicit feedback during training and is specific to the particular fluency manipulation used during training. Moreover, it was found that the reversal did not generalize to similar memory judgments. The balance of experimental results suggest that the standard interpretation of fluency as indicating higher levels of familiarity is quite stable and is resistant to reinterpretation.     

Family members' unique perspectives of the family: examining their scope, size, and relations to individual adjustment

Using the McMaster Family Assessment Device (Epstein, Baldwin, & Bishop, 1983) and incorporating the perspectives of adolescent, mother, and father, this study examined each family member's "unique perspective" or nonshared, idiosyncratic view of the family. We used a modified multitrait-multimethod confirmatory factor analysis that (a) isolated for each family member's 6 reports of family dysfunction the nonshared variance (a combination of variance idiosyncratic to the individual and measurement error) from variance shared by 1 or more family members and (b) extracted common variance across each family member's set of nonshared variances. The sample included 128 families from a U.S. East Coast metropolitan area. Each family member's unique perspective generalized across his or her different reports of family dysfunction and accounted for a sizable proportion of his or her own variance in reports of family dysfunction. In addition, after holding level of dysfunction constant across families and controlling for a family's shared variance (agreement regarding family dysfunction), each family member's unique perspective was associated with his or her own adjustment. Future applications and competing alternatives for what these "unique perspectives" reflect about the family are discussed.     

A longitudinal study of friends with benefits relationships

Friends with benefits relationships (FWBRs) uniquely combine friendship with sexual activity but differ from romantic relationships in that they may be less likely to be exclusive or long lasting. A longitudinal analysis of the trajectory of FWBRs is presented, in which participants in FWBRs at Time 1 reported on their relationship outcomes at Time 2 (N = 192). Results demonstrated that a plurality of FWBRs transitioned into having no relationship of any kind at Time 2 (31%). Those who wanted their FWBR to transition into a friendship typically obtained that outcome (59%), whereas those who wanted to transition into a romantic relationship did not (15%). Time 2 relationship status predictors and further implications of FWBR trajectories are discussed.