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.     

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.     

Motivational Antecedents and Consequences of the Mother–Adolescent Communication

Communication between parents and their children represents an important factor of family socialization. Nevertheless, little is known about why parents communicate in different ways and how these qualitative differences in parent–child communication may affect the child. Building on self-determination theory, the present study focuses on motivational antecedents of need-supportive communication as a function of parental child-related beliefs (i.e., long-term goals that parents have set for their children’s future, and parental child-related behavior expectations in terms of parental dissatisfaction or satisfaction with child behavior). Moreover, the effect of perceived need-supportive communication on children’s prosocial behavior and (externalizing and internalizing) behavioral difficulties will be addressed. Three waves of data from 1125 mothers and adolescents aged between 10 and 17 years were analyzed using growth-curve modeling. We found linearly increasing trajectories in extrinsic parental goals for children and dissatisfaction with child behavior, and decreasing trajectories of need-supportive communication. Individual differences do not vary significantly over time. In addition, holding extrinsic parental goals for children positively predicts parents’ dissatisfaction with their child’s behavior and negatively predicts need-supportive communication. Parents’ dissatisfaction with their child’s behavior also contributes to decreasing need-supportive communication. As expected, need-supportive communication predicts prosocial behavior and externalizing behavioral difficulties. When need-supportive communication decreases over time, both externalizing and internalizing behavioral difficulties increase. Furthermore, the effect of mothers beliefs on adolescents socioemotional development was mediated through perceived mother’s communication quality. These results suggest that parental child-related beliefs are important motivational antecedents of parent–child communication that may prevent behavioral difficulties.     

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.     

Differential Effects of Racial Socialization Messages for African American Adolescents: Personal Versus Institutional Racial Discrimination

Racial socialization is one factor known to attenuate the negative consequences of racial discrimination on adolescents’ anger and depressive symptoms. However, little is known about whether racial socialization messages addressing cultural and racial pride and messages preparing youth for racial discrimination and racial barriers function differently depending upon whether adolescents perceive personal versus institutional racial discrimination. Thus, the present study examined whether racial socialization messages emphasizing racial pride and racial barriers protected against anger and depressive symptoms for African American adolescents’ experience of personal and institutional racial discrimination. Participants were a community sample of 106 urban African American adolescents (57 % girls; mean age = 15.41) residing in a large metropolitan area. Regression analyses revealed that personal racial discrimination was positively associated with anger for youth reporting low cultural pride reinforcement, and positively associated with depressive symptoms for youth reporting low cultural alertness to discrimination; there were no associations between personal racial discrimination and anger or depressive symptoms for youth reporting high racial socialization messages. Neither cultural pride nor racial barrier racial socialization message protected against institutional racial discrimination. Findings suggest that the protective effects of racial socialization messages vary based on the type of racial discrimination adolescents experience.     

The Indirect Effect of Early Experiences on Deliberate Self-Harm in Adolescence: Mediation by Negative Emotional States and Moderation by Daily Peer Hassles

The present study examines whether early experiences of threat, subordination and devaluation with family influence adolescents’ negative emotional states and subsequently deliberate self-harm; and if this effect is conditioned by daily peer hassles. The sample consisted of 441 adolescents (57.6 % female) with ages between 13 and 18 years old from middle and high schools. Participants completed self-report instruments measuring early memories of threat, subordination and devaluation, daily peer hassles, negative affect and deliberate self-harm behaviors. Results from conditional process analysis showed that adolescents who feel devalued and experience threat and submission within family tend to endorse high levels of negative affect, which in turn accounts for increased endorsements on deliberate self-harm. Moreover, the impact of negative affect on deliberate self-harm is amplified by the presence of moderate and high levels of daily peer hassles. This study suggests the relevance of assessing and intervening on type of emotional memories (i.e., threat, subordination and devaluation), daily disruptions with peers and negative emotional states with adolescents who self-injure. These findings may be useful in the development of preventive and intervention programs for reducing deliberate self-harm in adolescence.     

Made in America: Perspectives on Friendship in West African Immigrant Families

This qualitative study compared West African immigrant parents’ and adolescents’ perspectives on parental monitoring of adolescents’ peer groups. Parents (n = 31) and adolescent children (n = 25) were interviewed using focus groups and individual interviews, and data were analyzed using a grounded theory approach. Parents expressed a general concern about external influences on their children, particularly their mistrust of their children’s friends. Adolescents reported that they were aware of their parents’ fears and described their attempts to manage their parents’ concerns while simultaneously maintaining friendships with same-ethnic and other-ethnic peers. This study offers both parent and adolescent perspectives in an effort to better understand adolescents’ peer socialization and parental monitoring among West African immigrant families, one of the fastest growing demographic groups in the United States. Recommendations for mental health professions are discussed.