Assessment and Treatment of Insomnia in Adults: A Guide for Clinicians

Insomnia leads to disrupted sleep and daytime fatigue. Many people who have this disorder look to the medical profession for treatment; however, it has been demonstrated that psychological approaches are usually more efficacious over the long term. Furthermore, such interventions are safe, cost effective, brief, and do not require extensive expertise. The authors provide an overview of the current best practices in assessment and treatment to encourage counselors to use these techniques when treating clients with insomnia.     

Attentional processes and meditation

Visual attentional processing was examined in adult meditators and non-meditators on behavioral measures of change blindness, concentration, perspective-shifting, selective attention, and sustained inattentional blindness. Results showed that meditators (1) noticed more changes in flickering scenes and noticed them more quickly, (2) counted more accurately in a challenging concentration task, (3) identified a greater number of alternative perspectives in multiple perspectives images, and (4) showed less interference from invalid cues in a visual selective attention task, but (5) did not differ on a measure of sustained inattentional blindness. Together, results show that regular meditation is associated with more accurate, efficient, and flexible visual attentional processing across diverse tasks that have high face validity outside of the laboratory. Furthermore, effects were assessed in a context separate from actual meditation practice, suggesting that meditators’ better visual attention is not just immediate, but extends to contexts separate from meditation practice.     

Socioeconomic Status and Psychological Function in Children with Chromosome 22q11.2 Deletion Syndrome: Implications for Genetic Counseling

The purpose of this study is to examine the association between parental socio-economic status (SES) and childhood neurocognition and behavior in children with chromosome 22q11.2 deletion syndrome (22q11DS). Although undoubtedly, the deletion of genes in the 22q11.2 interval is primarily responsible for the psychological manifestations, little is known about the role of the environment in either mitigating or contributing to these problems. We examined the association of parental socio-economic status (SES) with cognition and behavior in children with 22q11DS (n = 65) and matched healthy control subjects (n = 52), since SES is a component of family resources. We found that in children with 22q11DS, higher SES correlated with better overall functioning (p < .01) and social skills (p < .01), and less frequent oppositional defiant behavior (p < .001). These findings were in contrast to the control subjects in whom SES correlated with cognition and achievement, but not behavior. Our results indicate that environmental factors influence the behavioral phenotype in children with 22q11DS, providing a framework for developing appropriate interventions. As such, genetic counseling for families with 22q11DS may include consideration of family resources and inclusion of other health professionals, such as social workers, to explore with the family available social supports and resources.     

Driving impairs talking

It is well known that conversation (e.g, on a cell phone) impairs driving. We demonstrate that the reverse is also true: Language production and comprehension, and the encoding of the products of comprehension into memory, are less accurate when one is driving. Ninety-six pairs of drivers and conversation partners engaged in a story-retelling task in a driving simulator. Half of the pairs were older adults. Each pair completed one dual-task block (driving during the retelling task) and two single-task control blocks. The results showed a decline in the accuracy of the drivers’ storytelling and of their memory for stories that were told to them by their nondriving partners. Speech production suffered an additional cost when the difficulty of driving increased. Measures of driving performance suggested that the drivers gave priority to the driving task when they were conversing. As a result, their linguistic performance suffered.     

Is There Room for ‘Development’ in Developmental Models of Information Processing Biases to Threat in Children and Adolescents?

Clinical and experimental theories assume that processing biases in attention and interpretation are a causal mechanism through which anxiety develops. Despite growing evidence that these processing biases are present in children and, therefore, develop long before adulthood, these theories ignore the potential role of child development. This review attempts to place information processing biases within a theoretical developmental framework. We consider whether child development has no impact on information processing biases to threat (integral bias model), or whether child development influences information processing biases and if so whether it does so by moderating the expression of an existing bias (moderation model) or by affecting the acquisition of a bias (acquisition model). We examine the extent to which these models fit with existing theory and research evidence and outline some methodological issues that need to be considered when drawing conclusions about the potential role of child development in the information processing of threat stimuli. Finally, we speculate about the developmental processes that might be important to consider in future research.     

Insight-Related Challenges in the Treatment of Hoarding

Compulsive hoarding is a chronic and debilitating condition that has proven difficult to treat. The cognitive behavioral approaches that have otherwise been successful for people suffering from obsessive-compulsive disorder do not work very well for hoarding (Abramowitz, Franklin, Schwartz, & Furr, 2003). Many have suggested that this is due to the ego-syntonic nature of the symptoms and the accompanying lack of insight. This paper describes several challenges related to insight that limit the effectiveness of traditional cognitive behavioral approaches for compulsive hoarding. Problems with anosognosia, overvalued ideation, and defensiveness that characterize hoarding are described and suggestions offered for dealing with them.     

Introduction

Spiritual and religious beliefs and practices are commonplace in the general population of North America today. In recognition of this fact, research on the interplay of spirituality, religion, and psychological variables increased substantially over the past 3 decades; a recent PsycInfo search identified over 28,000 scientific contributions to this area. However, the relevance of spirituality and religion to clinical practice remains poorly understood. As a result, many practitioners of empirically supported treatments may be reticent to address spirituality and religion in the course of their work. The intent of this special series is to help demystify this topic with the hope of increasing dissemination of spiritually sensitive, empirically supported treatments. The authors in this series cast some light on this understudied topic by highlighting several salient spiritual and religious issues in behavior change. Moreover, based on case material, the authors illustrate how to assess for and address both adaptive and maladaptive utilizations of spirituality and religion in the practice of cognitive behavior therapy. This introductory paper presents a rationale for why it is important to address this topic, and provides an overview of recent research developments in the creation of spiritually integrated psychosocial treatments.     

What Accounts for Heterosexual Women’s Negative Emotional Responses to Lesbians?: Examination of Traditional Gender Role Beliefs and Sexual Prejudice

This study examined a pathway to heterosexual women’s experience of anger and anxiety in response to lesbian interactions. Participants were 149 18–30 year old heterosexual female undergraduates (56% African American) from a southeastern United States university. Participants completed measures of female gender role beliefs, sexual prejudice, and state affect, viewed a video depicting relationship behavior between a female–female or male–female dyad, and again completed a measure of state affect. Results indicated that traditional beliefs about women were associated with higher levels of sexual prejudice toward lesbians. In turn, higher levels of sexual prejudice predicted increased anger (not anxiety) in response to the female–female, but not the male–female, dyad. Findings elucidate determinants of heterosexual women’s anger, and potentially aggression, toward lesbians.