Habitual reappraisal in context: peer victimisation moderates its association with physiological reactivity to social stress

Although the emotion regulation strategy of reappraisal has been associated with adaptive outcomes, there is a growing evidence that it may not be adaptive in all contexts. In the present study, adolescents reported their use of habitual reappraisal and their experiences with peer victimisation, a chronic stressor that is associated with reduced well-being in this population. We examined how these variables predicted physiological reactivity (vagal withdrawal and changes in pre-ejection period) during a social stressor (i.e., Trier Social Stress Task). In line with previous research, at high levels of victimisation, habitual reappraisal predicted adaptive physiological reactivity (i.e., greater vagal withdrawal). Conversely, at low levels of victimisation, habitual reappraisal predicted maladaptive physiological reactivity (i.e., blunted vagal withdrawal). These findings were specific to parasympathetic reactivity. They suggest that habitual reappraisal may exert different effects on parasympathetic reactivity depending on the presence of stressors, and highlight the importance of examining the role of contextual factors in determining the adaptiveness of emotion regulation strategies.     

The Use of Family History Questionnaires: An Examination of Genetic Risk Estimates and Genetic Testing Eligibility in the Non-responder Population

The use of mailed family history questionnaires (FHQs) has previously been established to be an effective method for obtaining family history information for the triage of patients for genetic counseling and genetic testing of hereditary breast and ovarian cancer syndrome; yet only 53% of patients complete their FHQ within 6 months from the date of mailing (Armel et al. Journal of Genetic Counseling, 18(4):366–378, 2009). Although literature exists evaluating why women may not attend genetic counseling, no data are currently available examining genetic risk or genetic testing eligibility in the population of patients not returning their FHQ (non-responders). Concern exists that if non-responders are not followed-up for the purpose of triage for genetic counseling, individuals at high-risk for a hereditary cancer syndrome may be missed. This article explores the demographics of the non-responder population to assess genetic risk estimates for mutations in the BRCA1 and BRCA2 genes and genetic testing eligibility as compared to a responder population of patients who completed a mailed FHQ. A total of 430 pedigrees were obtained, 215 from non-responders and 215 from responders. Results of this study indicate that 69% of non-responders were either unreachable by telephone (42%), declined an appointment (19%), or were previously seen in another center for a genetic counseling visit (8%). Additionally, results indicate that non-responders are less likely to be eligible for genetic testing (40%) as compared to responders (57%) (p = 0.0004). Together these data shed light on a population of patients for which limited information exists and suggest that we question how and to what extent clinics should pursue non-responders, particularly in light of global reductions in health care funding.     

Extreme Values of Maternal Serum Analytes in Second Trimester Screening: Looking Beyond Trisomy and NTD’s

Second trimester maternal serum screening can identify high risk pregnancies and fetuses at risk for birth defects (in addition to those in the standard interpretation). The purpose of this study was to quantify such risks to improve counseling. We compared outcomes of 692 pregnancies that had abnormal levels of at least one analyte with a cohort of 713 pregnancies with normal analytes. Increased risks include: demise with high AFP and low uE3; intrauterine growth restriction with high AFP, high and low hCG, and low uE3; placental abnormalities with high AFP; fetal stress with high AFP and high hCG. Birth defects are increased with high AFP, high hCG, and low hCG. When two or more analytes are abnormal, 46% have a poor outcome. Abnormal levels of maternal serum analytes provide information in addition to the risks for neural tube defects, Down syndrome, and trisomy 18. This information is important for counseling and pregnancy management.     

A tale of two negatives: differential memory modulation by threat-related facial expressions

Facial expressions serve as cues that encourage viewers to learn about their immediate environment. In studies assessing the influence of emotional cues on behavior, fearful and angry faces are often combined into one category, such as "threat-related," because they share similar emotional valence and arousal properties. However, these expressions convey different information to the viewer. Fearful faces indicate the increased probability of a threat, whereas angry expressions embody a certain and direct threat. This conceptualization predicts that a fearful face should facilitate processing of the environment to gather information to disambiguate the threat. Here, we tested whether fearful faces facilitated processing of neutral information presented in close temporal proximity to the faces. In Experiment 1, we demonstrated that, compared with neutral faces, fearful faces enhanced memory for neutral words presented in the experimental context, whereas angry faces did not. In Experiment 2, we directly compared the effects of fearful and angry faces on subsequent memory for emotional faces versus neutral words. We replicated the findings of Experiment 1 and extended them by showing that participants remembered more faces from the angry face condition relative to the fear condition, consistent with the notion that anger differs from fear in that it directs attention toward the angry individual. Because these effects cannot be attributed to differences in arousal or valence processing, we suggest they are best understood in terms of differences in the predictive information conveyed by fearful and angry facial expressions.     

Changes in alcohol intake in response to transdiagnostic cognitive behaviour therapy for eating disorders

Objective

The aim of this study was to examine how alcohol intake changes during and after transdiagnostic cognitive behaviour therapy for eating disorders (CBT-E). Additionally, the paper considers the relationship between alcohol consumption, eating disorder diagnosis and current major depressive episode at the time of first assessment.

Method

One hundred and forty nine outpatients with an eating disorder (body mass index over 17.5) were divided into high or low alcohol intake groups (HIG and LIG) according to their intake at pre-treatment assessment. Their alcohol intake and eating disorder psychopathology were examined over the course of treatment and follow-up.

Results

There was no difference between the groups on response of the eating disorder to treatment. The HIG significantly reduced their alcohol intake following treatment whilst the intake of the LIG remained stable over the course of treatment and follow-up. There were no group differences in major depression and overall severity of eating disorder at baseline.

Conclusions

The response to CBT-E was not influenced by baseline level of alcohol use. The mean alcohol intake of the heavy drinking subjects decreased without being specifically addressed by the treatment.     

Gender Differences in the Effects of Acute Stress on Spatial Ability

Although reports that men and women differ in spatial ability are common, recent research examining stress effects on spatial navigation have not included analyses of gender differences. The current study investigated cue perception and mental rotation after an acute cold-water hand immersion stress in 156 undergraduates from the western United States. Gender differences were observed in spatial performance and spatial anxiety. Discriminant analysis revealed that distal gradient cue identification and mental rotation reaction times as well as spatial anxiety differed among men and women exposed to the acute stress and their warm-water hand immersion controls. These results indicate that stress differentially alters spatial performance in men and women, and underscores the importance of assessing gender differences when examining spatial ability.     

Multicultural Competence–Focused Peer Supervision: A Multiple Case Study of Clinical and Counseling Psychology Trainees

In this longitudinal, qualitative case study, 21 clinical and counseling psychology trainees met in leaderless peer supervision groups for 1 training year to discuss multicultural aspects of their clinical work. Peer supervision sessions were audio recorded and transcribed, and the content was analyzed using thematic analysis. Results indicated that, despite the absence of experts to facilitate discussions, participants were able to focus on multicultural issues and generally benefited from this type of peer supervision. En este estudio de caso longitudinal y cualitativo, 21 alumnos de psicología clínica y consejería se reunieron en grupos de supervisión entre pares sin líderes durante un año de su formación para discutir aspectos multiculturales de su trabajo clínico. Se grabó y transcribió el audio de las sesiones de supervisión entre pares, y luego se analizó el contenido usando un análisis temático. Los resultados indicaron que, a pesar de la ausencia de expertos para facilitar las discusiones, los participantes fueron capaces de centrarse en los temas multiculturales y generalmente se beneficiaron de este tipo de supervisión entre pares.     

The role of atypical antipsychotics in glucose/insulin dysregulation and the evolving role of the psychiatrist in a new era of drug treatment options

This article examines the issue of atypical antipsychotics, glucose/insulin, and other metabolic derangements (ie, metabolic syndrome), including a general introduction to the health concerns of our patients, a review of the literature, possible mechanisms of antipsychotic induced glucose dysregulation, monitoring approaches, and management and prevention of metabolic syndrome. Literature review leads to mechanism hypotheses and risk estimations, leading to guidelines for monitoring and treatment. The patient population suffers from a higher degree of baseline metabolic dysregulation resulting in cardiovascular disease through components of the metabolic syndrome, and this risk increases with administration of atypical antipsychotic medication at different rates, depending on both drug and patient risk factors. The growing knowledge of mechanisms behind drug induced glucose/insulin and other metabolic dysregulation, as well as advances in pharmacogenomics, will help refine drug selection and monitoring for adverse, life-threatening metabolic effects.     

Switching languages, switching palabras (words): an electrophysiological study of code switching

Switching languages has often been associated with a processing cost. In this study, the authors used event-related potentials to compare switches between two languages with within-language lexical switches as bilinguals read for comprehension. Stimuli included English sentences and idioms ending either with the expected English words, their Spanish translations (code switches), or English synonyms (lexical switches). As expected, lexical switches specifically enhanced the N400 response in both context types. Code switches, by contrast, elicited an increased negativity over left fronto-central sites in the regular nonidiomatic sentences (250-450 ms) and a large posterior positivity (450-850 ms) in both context types. In addition, both lexical and code switches elicited a late frontal positivity (650-850 ms) relative to expected completions, especially in idioms. Analysis of the individual response patterns showed correlations with vocabulary skills in English and in Spanish. Overall, the electrophysiological data suggest that for some speakers in some contexts, the processing of a code switch may actually be less costly than the processing of an unexpected within-language item.