Nonnormality and divergence in posttreatment alcohol use: reexamining the Project MATCH data "another way."

Alcohol lapses are the modal outcome following treatment for alcohol use disorders, yet many alcohol researchers have encountered limited success in the prediction and prevention of relapse. One hypothesis is that lapses are unpredictable, but another possibility is the complexity of the relapse process is not captured by traditional statistical methods. Data from Project Matching Alcohol Treatments to Client Heterogeneity (Project MATCH), a multisite alcohol treatment study, were reanalyzed with 2 statistical methodologies: catastrophe and 2-part growth mixture modeling. Drawing on previous investigations of self-efficacy as a dynamic predictor of relapse, the current study revisits the self-efficacy matching hypothesis, which was not statistically supported in Project MATCH. Results from both the catastrophe and growth mixture analyses demonstrated a dynamic relationship between self-efficacy and drinking outcomes. The growth mixture analyses provided evidence in support of the original matching hypothesis: Individuals with lower self-efficacy who received cognitive behavior therapy drank far less frequently than did those with low self-efficacy who received motivational therapy. These results highlight the dynamical nature of the relapse process and the importance of the use of methodologies that accommodate this complexity when evaluating treatment outcomes.     

Stress-response-dampening effects of alcohol: attention as a mediator and moderator

The present study sought to characterize alcohol's stress-response-dampening (SRD) effects on multiple measures of stress and whether these effects are mediated by reductions in sustained attention and, further, whether baseline levels of sustained attention moderate SRD. One hundred six men consumed either an alcohol (0.70 g/kg) or a placebo beverage prior to learning that they would deliver a self-disclosing speech. Structural equation models controlling for multiple baseline periods indicated that alcohol directly reduced self-reported anxiety and skin conductance levels in response to the stressor. Alcohol's effect on reducing heart rate response, in contrast, was indirect and mediated by effects on prestress baseline. As hypothesized, differences in sustained attention partially mediated the effects of alcohol on skin conductance (but not heart rate or self-reported anxiety) and served as a moderator of alcohol's effects on skin conductance response. Findings are discussed in terms of theoretical links among alcohol consumption, specific cognitive abilities, and stress reactivity.     

Comparing functional analysis and paired-choice assessment results in classroom settings

The results of a functional analysis of problem behavior and a paired-choice assessment were compared to determine whether the same social reinforcers were identified for problem behavior and an appropriate response (time allocation). The two assessments were conducted in classroom settings with 4 adolescents with mental retardation who engaged in severe problem behavior. Each student's classroom teacher served as the therapist for all phases of assessment. The two assessment procedures identified the same social reinforcers for problem and appropriate behavior for 3 of 4 participants.     

The relationship of social support to depressive symptoms during the transition to high school

The transition to high school is studied as a time when students may experience disruptions in their social support systems. Peer support, family support, and school belonging were hypothesized to be associated with adolescent adjustment, specifically depressive symptoms. Participants included 104 eighth graders and 101 ninth graders from a middle- to high-income, predominantly white community in southern Rhode Island. In year 2, 60 of the original 8th graders were surveyed as 9th graders. Three hypotheses were examined: Social support declines from 8th to 9th grade; depressive symptoms increase from 8th to 9th grade; and social support is significantly associated with depressive symptoms. The hypotheses were tested using cross-sectional and longitudinal analyses. Results indicated that 9th graders experienced more depressive symptoms and lower levels of school belonging as compared to the 8th graders. Changes in parent support and peer support were significantly associated with depressive symptoms in the transition to high school. Implications for increasing school belonging in the 9th grade are discussed.     

Age of acquisition affects object recognition: evidence from visual duration thresholds

The impact of age of acquisition (AoA) on object recognition was explored in three experiments measuring visual duration threshold (VDT) for the identification of pictures labelled with early and late acquired names. Participants viewed briefly displayed images preceded and followed by a pattern mask. The minimum display duration required for correct identification was shorter for pictures labelled with early names than for those labelled with late names. In Experiments 2 and 3 we explored the effects of two forms of visual degradation on VDT for pictures with early and late acquired names. Both degradation by superimposed visual elements, and degradation by contrast reduction extended VDT, but only the former interacted with AoA. We conclude that both AoA and degradation by superimposed visual elements affect the efficiency of visual object recognition, but only degradation by contrast and not AoA affects the efficiency of earlier pre-recognition processes.     

A prospective study of appraisals in childhood posttraumatic stress disorder

This study investigated the predictors of posttraumatic stress disorder (PTSD) in children following a diagnosis of traumatic injury. Children (N=76) aged between 7 and 13 who were admitted to hospital following injury were assessed within a month of trauma for acute stress disorder (ASD), negative appraisals, as well as parental stress reactions. Children (N=62) were re-assessed 6-months later for PTSD and negative appraisals. The majority of the variance of chronic posttraumatic stress was accounted for by negative appraisals about future harm. This study supports cognitive models of PTSD, and suggests that younger children who exaggerate their vulnerability after trauma exposure are high risk for PTSD after trauma.     

Rumination-focused cognitive behaviour therapy for residual depression: a case series

The treatment of chronic and recurrent depression is a priority for the development of new interventions. The maintenance of residual symptoms following acute treatment for depression is a risk factor for both chronic depression and further relapse/recurrence. This open case series provides the first data on a cognitive-behavioural treatment for residual depression that explicitly targets depressive rumination. Rumination has been identified as a key factor in the onset and maintenance of depression, which is found to remain elevated following remission from depression. Fourteen consecutively recruited participants meeting criteria for medication--refractory residual depression [Paykel, E.S., Scott, J., Teasdale, J.D., Johnson, A.L., Garland, A., Moore, R. et al., 1999. Prevention of relapse in residual depression by cognitive therapy--a controlled trial. Archives of General Psychiatry 56, 829-835] were treated individually for up to 12 weekly 60-min sessions. Treatment specifically focused on switching patients from less helpful to more helpful styles of thinking through the use of functional analysis, experiential/imagery exercises and behavioural experiments. Treatment produced significant improvements in depressive symptoms, rumination and co-morbid disorders: 71% responded (50% reduction on Hamilton Depression Rating Scale) and 50% achieved full remission. Treating depressive rumination appears to yield generalised improvement in depression and co-morbidity. This study provides preliminary evidence that rumination-focused CBT may be an efficacious treatment for medication--refractory residual depression.     

Enhanced perceived responsibility decreases metamemory but not memory accuracy in obsessive-compulsive disorder (OCD)

Mixed findings have been obtained in prior research with respect to the presence and severity of memory and metamemory deficits in obsessive-compulsive disorder (OCD). We tested the hypothesis that experimentally induced increments of subjective responsibility would lead to a disproportionately strong decline of memory confidence and enhanced response latencies in OCD while leaving memory accuracy unaffected. Twenty-eight OCD patients and 28 healthy controls were presented a computerized memory test framed with two different scenarios. In the neutral scenario, the participant was requested to imagine purchasing 15 items from a do-it-yourself store. In the recognition phase, the 15 needed items were presented along with 15 distractor items. The participant was asked to decide whether items were on his or her shopping list or not, graded by subjective confidence. In the responsibility scenario, the general experimental setup was analogous except that the participant now had to envision that he or she was a helper in a region recently struck by an earthquake, dispatched to provide 15 urgently needed goods from a nearby town. In line with prior work by our group, samples did not differ in either condition on memory accuracy in a subsequent recognition task. As hypothesized, OCD participants were less certain in their responses for the high responsibility condition than controls. Whereas patients and controls did not differ in their subjective estimates for memorized items, patients expressed stronger doubt that their earthquake mission was successful. The findings indicate that low memory confidence in OCD may only be elicited in situations where perceived responsibility is high and that patients may share higher performance standards ("good is not good enough") than controls when perceived responsibility is inflated.     

Do 9-month-old infants expect distinct words to refer to kinds?

In 3 experiments, 9-month-old infants' expectations for what distinct count noun labels refer to were investigated. In Experiment 1, a box was opened to reveal 2 objects inside during familiarization: either 2 identical objects or 2 different objects. Test trials followed the same procedure, except before the box was opened, the contents were described using 2 distinct labels ("I see a wug! I see a dak!") or the same label twice ("I see a zav! I see a zav!"). Infants who heard a label repeated twice looked longer at 2 different objects versus 2 identical objects, whereas infants who heard 2 distinct labels showed a different pattern of looking. Experiments 2 and 3 presented infants with object pairs that only differed in shape or color, and it was found that infants expected the different-shaped (but not the different-colored) objects to be labeled by distinct count nouns. Because the property of shape is a cue to kind membership and the property of color is not, these results suggest that even at the beginning of word learning, infants may expect distinct labels to refer to distinct kinds of objects.