Transdiagnostic Theory and Application of Family-Based Treatment for Youth with Eating Disorders

This paper describes the transdiagnostic theory and application of family-based treatment (FBT) for children and adolescents with eating disorders. We review the fundamentals of FBT, a transdiagnostic theoretical model of FBT and the literature supporting its clinical application, adaptations across developmental stages and the diagnostic spectrum of eating disorders, and the strengths and challenges of this approach, including its suitability for youth. Finally, we report a case study of an adolescent female with eating disorder not otherwise specified (EDNOS) for whom FBT was effective. We conclude that FBT is a promising outpatient treatment for anorexia nervosa, bulimia nervosa, and their EDNOS variants. The transdiagnostic model of FBT posits that while the etiology of an eating disorder is unknown, the pathology affects the family and home environment in ways that inadvertently allow for symptom maintenance and progression. FBT directly targets and resolves family level variables, including secrecy, blame, internalization of illness, and extreme active or passive parental responses to the eating disorder. Future research will test these mechanisms, which are currently theoretical.     

When seeking influences believing and promotes posttraumatic adaptation

Background: Theory and evidence link social support processes and self-efficacy appraisals in the promotion of adaptation following traumatic events. Dynamic causal processes, however, have not been examined longitudinally or in the context of mass-violence. This study tested whether quantity of social support seeking indirectly reduced distress severity among student survivors of mass university shootings. Hypotheses specified that the indirect effects of social support seeking on distress severity would occur through positively influencing perceived social support and self-efficacy, and that these effects would emerge and become stronger as posttraumatic stress symptom severity increased. Design: Path analysis via Mplus 7.2 was used to test the hypothesized moderated-serial-mediation model (conditional indirect effects). Methods: The sample (N = 1191) consisted of students enrolled at Virginia Tech during the 16 April 2007 shootings. Data were collected via online surveys at two time points, 3–4 months and 1-year post-shootings. Results: Hypotheses were supported, showing that the indirect effects of social support seeking on distress reduction occurred through perceived social support, which in turn influenced self-efficacy. These effects emerged and grew in strength as PTS severity increased. Conclusions: Clinical implications, including the need to consider contextual determinants of posttraumatic recovery, are discussed.     

Modular cognitive-behavioral therapy for body dysmorphic disorder

This study pilot tested a newly developed modular cognitive–behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-month follow-ups. At posttreatment, BDD and related symptoms (e.g., mood) were significantly improved. Treatment gains were maintained at follow-up. A relatively low drop-out rate, high patient satisfaction ratings, and patient feedback indicated that the treatment was highly acceptable to patients. To our knowledge, this represents the first test of a broadly applicable, individual psychosocial treatment for BDD.     

A test of the social development model during the transition to junior high with Mexican American adolescents

Mexican American adolescents have higher rates of externalizing problems than their peers from other ethnic and racial groups. To begin the process of understanding factors related to externalizing problems in this population, this study used the social development model (SDM) and prospective data across the transition to junior high school from 750 diverse Mexican American families. In addition, the authors examined whether familism values provided a protective effect for relations within the model. Results showed that the SDM worked well for this sample. As expected, association with deviant peers was the primary predictor of externalizing behaviors. There was support for a protective effect in that adolescents with higher familism values had slower rates of increase in association with deviant peers from 5th to 7th grades than those with lower familism values. Future research needs to determine whether additional culturally appropriate modifications of the SDM would increase its usefulness for Mexican American adolescents.     

Family structure and family processes in Mexican-American families

Despite increases in single-parent families among Mexican Americans, few studies have examined the association of family structure and family adjustment. Utilizing a diverse sample of 738 Mexican-American families (21.7% single parent), the current study examined differences across family structure on early adolescent outcomes, family functioning, and parent-child relationship variables. Results revealed that early adolescents in single-parent families reported greater school misconduct, conduct disorder/oppositional deviant disorder, and major depressive disorder symptoms, and greater parent-child conflict than their counterparts in 2-parent families. Single-parent mothers reported greater economic hardship, depression, and family stress. Family stress and parent-child conflict emerged as significant mediators of the association between family structure and early adolescent outcomes, suggesting important processes linking Mexican-American single-parent families and adolescent adjustment.     

Appealing to common humanity increases forgiveness but reduces collective action among victims of historical atrocities

Appealing to common humanity is often suggested as a method of uniting victims and perpetrators of historical atrocities. In the present experiment (N = 109), we reveal that this strategy may actually work against victim groups' best interests. Appealing to common humanity (versus intergroup identity) increased forgiveness of perpetrators but independently also served to lower intentions to engage in collective action. Both effects were mediated but not moderated by reduced identification with the victim group. We, thus reveal an important feature of appeals to common humanity: That this strategy may reduce social change at the same time as helping to promote more positive intergroup attitudes. These novel findings extend research on the human identity to a new theoretically interesting and socially important domain. Copyright © 2011 John Wiley & Sons, Ltd.     

Reason and Pareto‐Optimization

This paper takes up David Gauthier's most recent (2013) defense of the rationality of cooperation in prisoner's dilemmas. In that defense, Gauthier argues for a Pareto‐optimizing theory of rational choice. According to Gauthier, rational action should sometimes aim at Pareto‐optimization, and cooperation in prisoner's dilemmas is rational because it is Pareto‐optimizing. I argue that Pareto‐optimization cannot justify cooperation in the prisoner's dilemma in a manner that is also consistent with Gauthier's other desiderata. Either: (1) the rationality of cooperation must derive from what is beneficial for the group rather than what is beneficial for the individual, leaving the individual qua individual without any reason to cooperate, or (2) Gauthier cannot explain why defecting in prisoner's dilemmas is not also rational.     

Blame contagion: The automatic transmission of self-serving attributions

When people blame others for their mistakes, they learn less and perform worse. This problem is magnified when blame becomes embedded in the shared culture of groups and organizations. Yet, little is known about whether—and, if so, how—the propensity to blame spreads from one person to another. Four experiments addressed this issue, demonstrating that blame is socially contagious: observing an individual make a blame attribution increased the likelihood that people would make subsequent blame attributions for their own, unrelated, failures (Experiments 1, 2, and 4). Results also indicated that this “blame contagion” is due to the transmission of goals. Blame exposure led to the inference and adoption of a self-image protection goal (Experiment 3), and blame contagion was eliminated when observers had the opportunity to alleviate this self-image protection goal via self-affirmation (Experiment 4). Implications for research on causal attributions, social contagion, and cultural transmission are discussed.     

CONSISTENT VISUAL ANALYSES OF INTRASUBJECT DATA

Visual inspection of single‐case data is the primary method of interpretation of the effects of an independent variable on a dependent variable in applied behavior analysis. The purpose of the current study was to replicate and extend the results of DeProspero and Cohen (1979) by reexamining the consistency of visual analysis across raters. We recruited members of the board of editors and associate editors for the Journal of Applied Behavior Analysis to judge graphs on a 100‐point scale of experimental control and by providing a dichotomous response (i.e., “yes” or “no” for experimental control). Results showed high interrater agreement across the three types of graphs, suggesting that visual inspection can lead to consistent interpretation of single‐case data among well‐trained raters.