Managing Emotional Responses in Therapy: An Adapted EFT Supervision Approach

Therapists often encounter experiences in therapy that elicit emotionality, this could be in the form of self-of-the-therapist issues, compassion fatigue, or professional burnout. Whereas approaches to supervision for self-of-the-therapist issues recognize the need for accessing the supervisee’s emotionality, approaches have not focused on how the clinical and professional system could also be part of the cycle. We propose an adapted emotionally focused supervision approach that employs steps one through six of the EFT model. To display how this approach would work, we provide the example of work with longer-term clients. Working with longer-term clients can be a challenge for many therapists, and both the professional and client system come with factors increasing emotional risk to the therapist. Engaging the therapist’s emotionality through supervision has the potential to improve therapeutic outcomes, as well as reduce loss of good therapists in the field to professional burnout.     

Utility of the REDFLAGS Model for Supporting Community College Students’ Mental Health: Implications for Counselors

The counseling literature is lacking in research on supporting the mental health needs of the growing community college student population. A number of past investigators have demonstrated the utility of mental health literacy for supporting college students’ mental health on 4‐year universities. The present researchers examined the validity of the REDFLAGS model (a theoretical model for promoting mental health literacy) with a national stratified random sample (N = 640, stratified by age, gender, and ethnicity) of community college students. Collectively, the results of the confirmatory factor analysis, hierarchical logistic regression, and factorial analysis of variance supported the use of the model with community college students. Implications for enhancing counseling practice as well as directions for future research are provided.     

‘It was all intertwined’: Illness representations and self-management in patients with cancer and anxiety/depression

Objective: Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals’ multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression.

Design: A semi-structured qualitative research design with theoretical thematic analysis.

Main Outcome Measures: Multimorbid illness representations, coping behaviours, and self-management strategies.

Results: In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants’ most challenging illness also discussed.

Conclusions: People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.     

Indicators of Self-rated Driving across 3 Years among a Community-based Sample of Older Adults

These secondary analyses were conducted to identify predictors of self-rated driving ability over three years in community-dwelling older adults. From the Staying Keen in Later Life (SKILL) study, baseline and 3-year follow-up data for 426 older drivers were analyzed. Health, visual, physical, psychological and cognitive abilities were examined as prospective predictors of self-rated driving ability over a 3-year period, controlling for baseline self-rated driving. Results indicated that lower baseline ratings of self-efficacy and a diagnosis of osteoporosis independently predicted lower self-rated driving ability at 3-year follow-up. Interestingly, functional performance, such as visual, physical and cognitive abilities, were not predictive of self-ratings of driving ability across three years. Older drivers' self-ratings are more reflective of perceived self-efficacy rather than functional abilities. Self-screening tools for older drivers may be effective in improving the correspondence between perceived ability and actual ability in order to promote better informed decisions about driving regulation.     

Dissociations in visual attention deficits among persons with mild cognitive impairment

Impairments in visual attention and visual information processing have been identified as part of the neuropsychological features of Alzheimer's disease (AD), even in its earliest stages. There is increasing recognition that these deficits may be selective rather than global, with some attentional subtypes being more vulnerable than others. The few studies that have investigated attentional deficits in mild cognitive impairment (MCI), a putatively prodromal phase of AD, have not satisfactorily addressed the possible selectivity in attentional deficits in MCI. This study examined potential dissociations in visual attention deficits in MCI using a measure that assesses simple, divided, and selective attention. The results indicated a hierarchy of attentional impairments, with divided attention being the most affected and simple attention the least. Among participants with MCI, 53% showed evidence of impairment in divided attention compared to 19% of controls (OR = 4.81, p < .001). Poorer visual attention was also associated with poorer overall cognitive status. The implications of these findings for early identification of MCI, prevention of functional decline in MCI, and delay/reversal of cognitive degradation in MCI are discussed.     

The Predictive Utility of Narcissism among Childrenand Adolescents: Evidence for a Distinction betweenAdaptive and Maladaptive Narcissism

We examined the predictive utility of narcissism among a community sample of children and adolescents (N=98) longitudinally. Analyses focused on the differential utility between maladaptive and adaptive narcissism for predicting later delinquency. Maladaptive narcissism significantly predicted self-reported delinquency at one-, two-, and three-year follow-ups. This pattern held even when considering other intrapersonal risk factors for conduct problems (i.e., callous-unemotional traits, impulsivity), parenting practices, and when controlling for earlier conduct problems. In addition, adaptive narcissism was predictive of delinquency in the absence of positive parenting practices, with maladaptive narcissism being particularly predictive of delinquency in the presence of negative parenting. The implications for understanding delinquency in terms of the social and motivational characteristics that are the hallmark of maladaptive narcissism are discussed.     

Testing the latent factor structure and construct validity of the Ten-Item Personality Inventory

Recent efforts have aimed to develop relatively short measures of the Five-Factor Model (FFM) of personality, particularly for when time and/or space is limited. We evaluate the Ten-Item Personality Inventory (TIPI), a non-proprietary FFM measure with two items per dimension. We use a latent variable methodology to examine the TIPI’s factor structure and convergent validity with the 50-item International Personality Item Pool (IPIP) FFM measure. We provide correlations between the scale scores and latent factors, and compare each measure’s pattern of correlations with measures of other individual difference constructs. Results were favorable in terms of the factor structure and convergent validity of the TIPI, particularly regarding the correlations between the respective latent factors of the TIPI and the IPIP–FFM measures.     

The Neuropsychology of HIV/AIDS in Older Adults

Highly active antiretroviral therapy is allowing increasing numbers of adults to age with HIV. The neuropsychological effects of aging with HIV are reviewed through three types of studies. First, the separate effects of HIV and aging on cognition are examined in studies that compare younger adults with HIV with neurologically normal older adults. Second, studies examine the impact of aging within samples of adults with HIV only. Third, providing the most critical evidence, are studies that assess cognition in younger and older adults with HIV relative to younger and older adults without HIV. In general research findings are inconclusive. Large individual differences among older adults with HIV as well as co-factors (APOE4 and detectable viral load) may account for inconsistent findings in the literature. A subgroup of older adults with HIV may be at greater risk for cognitive impairment, especially in attention functioning.