Therapist empathy,homework compliance,and outcome in cognitive behavioral therapy for generalized anxiety disorder: partitioning within- and between-therapist effects

Although client-perceived therapist empathy relates to positive therapy outcomes, including in cognitive behavioral therapy (CBT), little is known about how empathy exerts its ameliorative effect. One possible way is by promoting clients’ subsequent homework compliance, a variable that also predicts positive outcomes in CBT. The present study sought to investigate simultaneously, in the context of 43 therapist–client dyads receiving 15 sessions of CBT for generalized anxiety disorder, (1) the association of early client-perceived therapist empathy (averaged over sessions 1, 3, 5) with mid-treatment client homework compliance (averaged over sessions 6, 8, 10); (2) the association of mid-treatment homework compliance on client posttreatment worry severity; and (3) the indirect effect of early perceived therapist empathy on posttreatment worry through mid-treatment homework compliance. Given that clients were nested within therapists, we examined both within- and between-therapist differences in clients’ ratings of therapist empathy and homework compliance, and tested both of these indices as predictors of the relevant dependent variables in a multilevel model. At the within-therapist level (i.e., differences between clients within a given therapist’s caseload), greater early empathy was associated with greater mid-treatment homework compliance. At the between-therapist level (i.e., differences between therapists across all of their cases), greater between-therapist homework compliance was related to lower posttreatment worry. Finally, homework compliance was not found to mediate the relationship between empathy and posttreatment outcome. The results underscore the importance of parsing client and therapist effects, and are discussed with regard to their training and research implications.     

Community Resilience as a Metaphor, Theory, Set of Capacities, and Strategy for Disaster Readiness

Communities have the potential to function effectively and adapt successfully in the aftermath of disasters. Drawing upon literatures in several disciplines, we present a theory of resilience that encompasses contemporary understandings of stress, adaptation, wellness, and resource dynamics. Community resilience is a process linking a network of adaptive capacities (resources with dynamic attributes) to adaptation after a disturbance or adversity. Community adaptation is manifest in population wellness, defined as high and non-disparate levels of mental and behavioral health, functioning, and quality of life. Community resilience emerges from four primary sets of adaptive capacities--Economic Development, Social Capital, Information and Communication, and Community Competence--that together provide a strategy for disaster readiness. To build collective resilience, communities must reduce risk and resource inequities, engage local people in mitigation, create organizational linkages, boost and protect social supports, and plan for not having a plan, which requires flexibility, decision-making skills, and trusted sources of information that function in the face of unknowns.     

MK-801 improves retention in aged rats: implications for altered neural plasticity in age-related memory deficits

Alterations in N-methyl-d-aspartate receptor (NMDAR)-dependent synaptic plasticity, characteristic of aged rodents, may contribute to impaired memory with advanced age. The purpose of the current research was to examine whether NMDARs contribute to rapid forgetting on a spatial memory task. Aged (22-24 months) and adult (3-6 months) male Fischer 344 rats received 18 training trials, over a period of 3 to 4 h, on the spatial version of the Morris water maze. Immediately after training, a standard free-swim probe trial was administered to assess the acquisition of spatial bias, which was determined by the percent of time spent in the goal quadrant and the number of platform crossings. Rats then received injections of the noncompetitive NMDAR antagonist, (+)-10, 11-dihydro-5methyl-5H-dibenzo(a,b)cycloheptene-5,10 imine (MK-801, 0. 05 mg/kg, i.p.), or a vehicle injection of equal volume. Approximately 24 h later, rats were administered a second free-swim probe trial to assess retention of spatial bias. All age/drug groups exhibited a spatial bias on the acquisition probe, with adults generally outperforming the aged rats. On the retention probe, this spatial bias continued to be shown by adult rats, regardless of treatment. For the aged group, in contrast, only MK-801-injected rats maintained a spatial bias on the retention probe, suggesting that NMDAR activity may be involved in rapid forgetting during aging. Because blockade of NMDARs also may impair new learning, which may, in turn, protect previously stored information from retroactive interference, rats in a second experiment received post-training injections of scopolamine (0.05 mg/kg), a compound known to inhibit learning. However, scopolamine did not enhance retention in the aged group, consistent with the hypothesis that MK-801 influenced memory in aged rats through its actions on NMDAR-dependent synaptic plasticity.     

Why do doctored images distort memory?

Doctored images can cause people to believe in and remember experiences that never occurred, yet the underlying mechanism(s) responsible are not well understood. How does compelling false evidence distort autobiographical memory? Subjects were filmed observing and copying a Research Assistant performing simple actions, then they returned 2 days later for a memory test. Before taking the test, subjects viewed video-clips of simple actions, including actions that they neither observed nor performed earlier. We varied the format of the video-clips between-subjects to tap into the source-monitoring mechanisms responsible for the ‘doctored-evidence effect.’ The distribution of belief and memory distortions across conditions suggests that at least two mechanisms are involved: doctored images create an illusion of familiarity, and also enhance the perceived credibility of false suggestions. These findings offer insight into how external evidence influences source-monitoring.     

REVISING THE SES: A COLLABORATIVE PROCESS TO IMPROVE ASSESSMENT OF SEXUAL AGGRESSION AND VICTIMIZATION

The Sexual Experiences Survey (SES) assesses victimization and perpetration of unwanted sexual experiences (e.g., Koss, Gidycz, & Wisniewski, 1987 ). Revised versions of the SES that resulted from the work of the SES Collaboration are now available. This article reviews weaknesses of the SES that were identified, strengths that were preserved, and methodological considerations in the measurement of unwanted sexual experiences that informed the revisions. The primary changes include: more behavioral specificity; conversion to gender neutrality; full crossing of unwanted acts and coercive tactics; and revised and updated wording for assessing consent, alcohol-related incidents, unwanted acts, and coercive tactics. For illustration, the full text of the revised victimization version and its scoring rules are provided. The article concludes with suggestions for future research. These suggestions aim to involve researchers in a coordinated agenda to develop data that clarify methodological questions and contribute to continued improvement in assessing sexual victimization and perpetration.     

Formation for public life: Bonhoeffer's approach to theological education

This essay addresses the role of theological education in shaping how Christian leaders and institutions respond to public debate, conflict, and crisis by analyzing Bonhoeffer's approach to theological education in times of conflict and crisis. It argues that his pedagogical approach of education as formation for public life should inform our pedagogical practice, as the church increasingly engages in a diverse pluralistic public and political life.     

Improving Predictive Accuracy with a Combination of Human Intuition and Mechanical Decision Aids

This study examines the intuitive combination of human judgment and mechanical prediction under varied information conditions. As expected, mechanical prediction outperformed human intuition when based on the same information, but a combined approach was best when judges had access to relevant information not captured by the model (information asymmetry). The model was useful for differentiating between the event outcomes (improved slope), while eliminating the bias caused by base-rate neglect. Human intuition was useful for incorporating relevant information outside the scope of the model, resulting in improved slope and reduced judgment scatter. The addition of irrelevant information was detrimental to judgment accuracy, causing an increase in bias and a reduction in slope. These results provide insight intohowandwhencombining mechanical prediction and human intuition is likely to result in improved accuracy.