Ethical Considerations for Cognitive-Behavioral Therapists in Psychotherapy Research Trials

Psychotherapy research studies, which balance the pursuit of knowledge with the provision of treatment, can place unique demands on clinicians, patients, and research staff. However, the literature on ethical considerations in psychotherapy trials is minimal. The current paper depicts CBT community standards of practice in the context of two NIMH-funded treatment trials of major depression, both involving CBT and medication. We describe issues that arose; discuss the ethical considerations involved; and describe our course of action, along with our rationale.     

“I was and still am”: Narratives of Bisexual Marking in the #StillBisexual Campaign

This research investigated narratives of bi-erasure and bisexual marking by considering 53 video confessionals associated with the #StillBisexual campaign. #StillBisexual is a web-based campaign that targets myths about bisexuality and promotes bisexual identity visibility. Thematic analysis was conducted to identify emergent themes regarding the ways that individuals mark and make known their bisexuality. Three major themes of bisexual demarcation emerged including the enduring nature of bisexuality, defining bisexuality, and defining the self as a bisexual being. Discussion focuses on describing bisexual marking approaches by #StillBisexual participants and by analyzing the way bisexual demarcation challenges assumptions of monosexism and cisgenderism inherent to cultural conceptualizations of sexuality.     

Two faces of (dis)similarity in affective judgments of persons: contrast or assimilation effects revealed by morphs

The authors investigated the role of dissimilarity on context effects in person perception. Most research predicts similar people to be similarly evaluated and different people to be contrasted with each other. However, some research suggests that similarity may enhance comparison and contrast. To explain these opposite effects, the authors argue that dissimilarity may influence 2 different processes with opposite consequences. Dissimilarity may decrease common categorization and thus the likelihood of comparison, resulting in reduced contrast, whereas during comparison itself dissimilarity may increase the perceived dissimilarity of features and thereby increase contrast. To investigate this, the authors conducted 3 studies in which they manipulated dissimilarity by inserting morphs that were related or unrelated to the context and target faces before judgments were made. The results indicate that dissimilarity may affect the likelihood and the outcome of comparison, with contrasting consequences.     

Crosstalk between on-line and off-line processing of visual features

Three dual-task experiments were conducted to investigate the relation between immediate, on-line judgments about visual features and delayed, off-line judgments. One hypothesis (selective interference) predicted that dual-task performance would be challenged specifically within a visual dimension, as both tasks compete for the same resources. Another hypothesis (cost of switching) made the opposite prediction. In Experiment 1, participants performed either color or shape discriminations in the on-line and off-line visual tasks, with systematic variation of feature similarity between the on-line and off-line features. In Experiment 2, participants performed either color or shape discriminations in the off-line task and color discriminations in the on-line task, with no overlap between the on-line and off-line features. In Experiment 3, participants performed color discriminations in both the on-line and off-line tasks, with partially overlapping stimulus sets. Altogether, the data from the three experiments provided evidence in favor of the hypothesis of cost of switching. Stimulus–stimulus compatibility effects between features in the off-line task and those in the on-line task further underscored the perceptual nature of the crosstalk.     

The effects of diffuse and distinct affect

In a series of suboptimal priming studies, it was shown that both affective and nonaffective reactions to a stimulus may occur without awareness. Moreover, it was demonstrated that affective information is detected earlier than nonaffective information. Therefore, early reactions to an affect-laden stimulus (e.g., a smiling man) are cognitively unappraised and thus diffuse (e.g., "positive"), whereas later affective reactions can be more specific and distinct (e.g., "a smiling man"). Through variations of prime exposure (extremely short, moderately short) the impact of early diffuse and late distinct affect on judgment was investigated. Findings show that distinctness (and prime-target similarity) is an essential determinant of whether the effect of affect is null, assimilation, or contrast. Furthermore, whether affect priming activates diffuse or distinct reactions is a matter of a fraction of seconds.     

Mother-child separations among homeless and housed families receiving public assistance in New York City

We examined the incidence, characteristics, and predictors of separations of children from mothers in 543 poor families receiving public assistance, 251 of whom had experienced homelessness during the previous 5 years. Forty-four percent of the homeless mothers and 8% of housed mothers were separated from one or more children. A total of 249 children were separated from 110 homeless families and 34 children from 23 housed families. Children were placed with relatives and in foster care but were rarely returned to their mothers. Maternal drug dependence, domestic violence, and institutionalization predicted separations, but homelessness was the most important predictor, equivalent in size to 1.9 other risk factors. We infer that policies regarding child welfare and substance abuse treatment should be changed to reduce unnecessary placements. Studies of homeless children who remain with families may be biased if separated children are excluded.     

“Avant‐Garde of What?”: Surrealism Reconceived as Political Culture

However we may judge avant-garde art when we meet it, for us the phenomenon and idea are so present and evident that we do not stop, even momentarily, to wonder if we might be dealing with an illusion or an appearance rather than a reality, with a myth or a superstition rather than a concept.     

The efficacy of systemic therapy with adult patients: a meta-content analysis of 38 randomized controlled trials

Systemic therapy is a widely used psychotherapy approach. Yet there exist few systematic reviews on its efficacy. A meta-content analysis was performed to analyze the efficacy of systemic therapy for the treatment of mental disorders in adulthood. All randomized (or matched) controlled trials (RCT) evaluating systemic/systems oriented therapy in various settings (family, couple, individual, group, multifamily group therapy) with adult index patients suffering from mental disorders were identified by database searches and cross-references in other reviews. Inclusion criteria were: index patient diagnosed with a DSM or ICD listed mental disorder, trial published in any language up to the end of 2008. The RCTs were content analyzed according to their research methodology, interventions applied, and results. Thirty-eight trials published in English, German, Spanish, and Chinese were identified, 34 of them showing systemic therapy to be efficacious for the treatment of mood disorders, eating disorders, substance use disorders, mental and social factors related to medical conditions and physical disorders, and schizophrenia. Systemic therapy may also be efficacious for anxiety disorders. Results were stable across follow-up periods of up to 5 years. There is a sound evidence-base for the efficacy of systemic therapy for adult index patients with mental disorders in at least five diagnostic groups.     

When competition merges people's behavior: Interdependency activates shared action representations

Previous research suggests that friendly, cooperative situations cause one to integrate a co-actor's actions into one's own action system. Departing from an interdependency perspective, we predict the activation of shared action representations even in hostile, competitive situations as a result of attending to the intentions of the co-actor. To test this, in Experiment 1 we manipulated the interdependency between actor and co-actor in a joint Simon task and observed a stronger activation of shared action representations in a cooperative as well as competitive context compared to an independent context. Experiment 2 replicated the competitive context effect on activation of shared action representations and provided additional evidence for the mediating role of attending to others’ intentions by taking into account the individual tendency to attend to others’ intentions. Together, our findings suggest that interdependency merges people's behavior even in competitive contexts, which we argue encourage actors to attend to others’ intentions.     

Psychopathy in a forensic sample – the factor structure of the PCL:SV in a Danish forensic sample

The research literature reveals an ongoing debate regarding the most appropriate conceptualization of psychopathic personality disorder. Specifically, it is discussed to what degree antisocial behavior is part of the conceptualization of the psychopathy construct and what constitutes the best factor model of the Psychopathy Checklist scales. The aim of the present study is to consider the underlying factor structure of the PCL:SV (Psychopathy Checklist Screening Version) in a Danish sample as well as considering the role of antisocial behavior in the psychopathy construct. Data from a Danish forensic patient sample (N = 225) was used and item response theory (IRT), aonfirmatory factor analyses (CFA) and structural equations model (SEM) analyses were carried out. Overall, the findings suggest appropriate item and model fit for the PCL:SV as well as superiority of the three‐factor model over the four‐factor model. The results are discussed in relation to the broader concept of personality disorder as well as clinical practice in regards to violence risk assessments and treatment of psychopathy.