Disorganization and Individual Psychotherapy for Schizophrenia: A Case Report of Metacognitive Reflection and Insight Therapy

Despite being a characteristic symptom of schizophrenia, implications for therapy with persons experiencing prominent disorganization have received less attention in the psychotherapy literature than have other aspects of the disorder. As such, formal thought disorder may be viewed largely as a barrier to effective participation in therapy. In contrast, though, a range of writers from varied traditions have stressed that this feature of schizophrenia is meaningful and improved coherence of speech is an important and viable component of treatment and recovery. This paper suggests that an emergent integrative psychotherapy, metacognitive reflection and insight therapy (MERIT), may be well-suited for work with persons experiencing disorganization symptoms. A brief overview of MERIT is provided, followed by a case report of an 18-month course of therapy with a man with severely disorganized speech.     

Targeting Insight in First Episode Psychosis: A Case Study of Metacognitive Reflection Insight Therapy (MERIT)

One aspect of schizophrenia contributing to its complexity is the lack of insight individuals often have into their illness. While poor insight is prevalent throughout the course of the illness, more severe levels are associated with first-episode psychosis (FEP). Interventions addressing insight are necessary but current treatments have been shown to have limited effectiveness. Thus, a novel intervention, Metacognitive Reflection and Insight Therapy (MERIT), is being studied for its efficacy of improving insight in individuals with schizophrenia spectrum disorders. MERIT is an integrative metacognitive therapy consisting of eight elements to assist clients in improving their ability to form complex ideas about themselves and others and to use this knowledge to respond to psychological problems. The present study is a case illustration of the implementation of MERIT to improve insight in FEP. Clinical outcomes were assessed and results showed that the client improved in both metacognition and insight. With replication, these results suggest that integrative metacognitive psychotherapy may serve as an intervention that improves insight in FEP, which marks an important step toward improved interventions for individuals with psychosis.     

Different ways to get the job done: comparing the effects of intellectual stimulation and contingent reward leadership on task‐related outcomes

Two experiments were conducted to compare the effects of intellectual stimulation and contingent reward leadership on performance, task enjoyment, and extra effort. Participants (N = 78 and N = 158) viewed one of three videos and performed an in‐basket exercise. Several interesting differences emerged. Across both studies, participants in the control and contingent reward leadership conditions generated more ideas than their counterparts in the intellectual stimulation condition. Additionally, participants reported more willingness to exert extra effort when the leader was either intellectually stimulating or emphasized contingent reward leadership, as compared to the control condition. Finally, while task enjoyment was higher in the contingent reward leadership condition than in the control condition in Study 1, no significant differences emerged among conditions for enjoyment in Study 2.     

Willful ignorance and self-deception

Willful ignorance is an important concept in criminal law and jurisprudence, though it has not received much discussion in philosophy. When it is mentioned, however, it is regularly assumed to be a kind of self-deception. In this article I will argue that self-deception and willful ignorance are distinct psychological kinds. First, some examples of willful ignorance are presented and discussed, and an analysis of the phenomenon is developed. Then it is shown that current theories of self-deception give no support to the idea that willful ignorance is a kind of self-deception. Afterwards an independent argument is adduced for excluding willful ignorance from this category. The crucial differences between the two phenomena are explored, as are the reasons why they are so easily conflated.     

Gentzenization of Trilattice Logics

Sequent calculi for trilattice logics, including those that are determined by the truth entailment, the falsity entailment and their intersection, are given. This partly answers the problems in Shramko-Wansing (J Philos Logic 34:121–153, 2005).     

Adolescent Egocentrism and the Illusion of Transparency: Are Adolescents as Egocentric as we Might Think?

The illusion of transparency, or people’s tendency to believe their thoughts and feelings as more apparent to others than they actually are, was used to investigate adolescent egocentrism. Contrary to previous research demonstrating heightened adolescent egocentrism, adolescents exhibited similar levels of egocentrism to adults. In experiment 1, 13-14 year-olds and adult participants both truthfully described and lied about a series of pictures. Both adolescent and adult liars indicated that they were more confident that other participants would know when they were lying, than other participants actually indicated. In experiment 2, 13-14 year-olds, 15-16 year-olds and adult participants read to an audience. The illusion of transparency effect manifested itself differently according to gender: Female participants indicating that they looked more nervous than audiences thought, whilst male participants indicating that they were more entertaining than audiences thought. Results were interpreted using simulation theory, and suggested that adolescents might not be as egocentric as previously thought.     

Grabbing Your Bootstraps: Threats to Economic Order Boost Beliefs in Personal Control

Individuals are motivated to maintain perceptions of order and predictability in the social environment. Compensatory control theory proposes that when an individual’s perception of her or his own control is threatened, the individual can turn to external systems that may provide a perception of control (e.g., organized government). Conversely, the theory also predicts that when external systems of control are threatened, individuals may respond by exaggerating perceptions of personal control, although this effect has received relatively little empirical support. In the present study, we examined how a threat to an external system of economic control affects individual perceptions of personal control. Specifically, we found that a threat to the perceived distribution of economic resources based on hard work and effort (i.e., meritocracy) led to greater perceptions of personal control. Moreover, this increase in personal control directly increased participants’ optimism about their future economic outcomes. This study provides important insight into the broad influence of external systems on individuals' perceptions of personal control and assessment of future action.     

The Integration of Noninvasive Prenatal Screening into the Existing Prenatal Paradigm: a Survey of Current Genetic Counseling Practice

Since its introduction four years ago, noninvasive prenatal screening for fetal aneuploidy (NIPS) has been widely adopted as a screening tool for women at a high risk for fetal aneuploidy. As use expands into the general population, questions arise concerning the integration of NIPS into preexisting screening paradigms. This study aims to examine the use of NIPS in current practice among prenatal counselors, predominantly in the United States, in order to inform strategies for the optimal use of both new and existing screening techniques. We electronically surveyed 208 members of the National Society of Genetic Counselors to ascertain how NIPS is currently being used. Genetic counselors were also queried as to the advantages and disadvantages of offering NIPS to all patients regardless of a priori risk. Results indicate substantial variation in practice regarding which patients are offered NIPS and how counselors have incorporated this technology into existing screening routines. The majority of participants report offering NIPS in conjunction with another method of screening for fetal aneuploidy, indicating that NIPS is being used as an addition rather than as a replacement. These screening methods primarily include nuchal translucency (NT) (45.1 %, n = 78) and first trimester serum screening, with or without an NT (19.7 %, n = 34). Furthermore, the majority report that they would be concerned about losing the clinical value of an NT in a complete transition to NIPS (85.4 %, n = 164). Counselors are evenly split on the merits of expanding the use of NIPS to the general population (con: 55.3 %, n = 105; pro: 44.7 %, n = 85). The lack of consensus suggests that updated practice guidelines might benefit counselors. In addition, respondents emphasized the need to better educate patients and providers about the risks, benefits, and limitations of the test.     

Acceptability and Feasibility of Peer Assisted Supervision and Support for Intervention Practitioners: A Q-methodology Evaluation

Evidence-based interventions often include quality improvement methods to support fidelity and improve client outcomes. Clinical supervision is promoted as an effective way of developing practitioner confidence and competence in delivery; however, supervision is often inconsistent and embedded in hierarchical line management structures that may limit the opportunity for reflective learning. The Peer Assisted Supervision and Support (PASS) supervision model uses peer relationships to promote the self-regulatory capacity of practitioners to improve intervention delivery. The aim of the present study was to assess the acceptability and feasibility of PASS amongst parenting intervention practitioners. A Q-methodology approach was used to generate data and 30 practitioners volunteered to participate in the study. Data were analyzed and interpreted using standard Q-methodology procedures and by-person factor analysis yielded three factors. There was consensus that PASS was acceptable. Participants shared the view that PASS facilitated an environment of support where negative aspects of interpersonal relationships that might develop in supervision were not evident. Two factors represented the viewpoint that PASS was also a feasible model of supervision. However, the third factor was comprised of practitioners who reported that PASS could be time consuming and difficult to fit into existing work demands. There were differences across the three factors in the extent to which practitioners considered PASS impacted on their intervention delivery. The findings highlight the importance of organizational mechanisms that support practitioner engagement in supervision.