Cumulative Risk,Emotion Dysregulation,and Adjustment in South African Youth

Research on cumulative risk is growing, however, little work has occurred in low- or middle-income countries, and few studies have focused on processes linking risk to outcomes. This study explored relations between components of cumulative risk and adjustment in a sample of 324 South African youth (M age?=?13.11 years; SD?=?1.54 years; 65% female; 56% Black/African; 14% Colored; 23% Indian; 7% White), and tested competing models of emotion dysregulation as a mediator or moderator of risk—adjustment links. Data was collected from youth and their female caregivers during home interviews. Structural equation models and regression analyses accounting for age and sex contributions revealed that emotion dysregulation mediated associations between sociodemographic risk and internalizing symptoms, externalizing problem behavior, and drug use severity, and moderated links between psychosocial risk and internalizing symptoms and externalizing problem behavior. For the mediator models, sociodemographic risk was associated with impaired emotion regulation, which in turn was linked with heightened adjustment difficulties. For the moderator models, psychosocial risk was linked with adjustment problems only when emotion dysregulation was high. These data indicate the importance of disentangling components of cumulative risk. Future research within the South African cultural context might build on these findings by adapting and testing school- or family-based prevention or intervention programs that include modules on emotion regulation.     

Creating state of the art,next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions

Decades of research and more than 20 randomized controlled trials show that Virtual Reality exposure therapy (VRET) is effective in reducing fear and anxiety. Unfortunately, few providers or patients have had access to the costly and technical equipment previously required. Recent technological advances in the form of consumer Virtual Reality (VR) systems (e.g. Oculus Rift and Samsung Gear), however, now make widespread use of VRET in clinical settings and as self-help applications possible. In this literature review, we detail the current state of VR technology and discuss important therapeutic considerations in designing self-help and clinician-led VRETs, such as platform choice, exposure progression design, inhibitory learning strategies, stimuli tailoring, gamification, virtual social learning and more. We illustrate how these therapeutic components can be incorporated and utilized in VRET applications, taking full advantage of the unique capabilities of virtual environments, and showcase some of these features by describing the development of a consumer-ready, gamified self-help VRET application for low-cost commercially available VR hardware. We also raise and discuss challenges in the planning, development, evaluation, and dissemination of VRET applications, including the need for more high-quality research. We conclude by discussing how new technology (e.g. eye-tracking) can be incorporated into future VRETs and how widespread use of VRET self-help applications will enable collection of naturalistic “Big Data” that promises to inform learning theory and behavioral therapy in general.     

Supervisory countertransferences and impingements in evaluating readiness for graduation: Always present,routinely under‐recognized

Utilizing detailed, in‐depth material from supervisory hours from around the world (explored in End of Training Evaluation groups), this paper shows that supervisors are subject to multiple, diverse and, at times, ongoing intense countertransferences and impingements on their ability to evaluate candidates’ progress. Multiple external and internal sources of these impingements are explored. It is suggested that supervisory countertransferences and their manifestation in parallel enactments remain under‐recognized, their impact underappreciated, and the information they contain underutilized. It is argued that the recognition, containment, and effective use of the parallel process phenomena and supervisory countertransferences are essential in order to evaluate candidates’ progression and readiness to graduate. Common signals of such entanglements in the supervisor's evaluative function are identified. Three remedies, each of which provides a ‘third,’ are offered to assist supervisors in making effective use of their countertransference: self‐supervision, consultation, and institutional correctives.     

Differentiating Bipolar Disorder from Major Depressive Disorder Using the MMPI-2-RF: A Receiver Operating Characteristics (ROC) Analysis

We examined the utility of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) to differentiate patients with lifetime bipolar disorder (BD) from patients with lifetime major depressive disorder (MDD), and to differentiate patients with BD who are currently depressed from patients with current MDD. Sixty-one patients with BD (BD-I n = 51, BD-II n = 10) and 381 patients with MDD were administered the MMPI-2; MMPI-2-RF scale scores were derived from these MMPI-2 protocols. Receiver operating characteristics analysis revealed that the MMPI-2-RF Activation (ACT) scale had the largest Area Under the Curve (AUC), which was 0.74. Using a cut-off score of 4 on the ACT scale resulted in 71% of patients being correctly classified as having BD or MDD (sensitivity = 0.67, specificity = 0.71). An examination of currently depressed patients with BD (n = 29) and a randomly selected sample of MDD patients (n = 29) revealed that the ACT scale correctly classified 72% of patients (AUC = 0.75, sensitivity = 0.69, specificity = 0.76). Implications and limitations of these findings were discussed.     

Coronary Intervention Improves Disease Specific Health-Related Quality of Life but Not Individualised Quality of Life: A Potential Response Shift Effect?

To explore potential response shift effects with different quality of life (QoL) instruments in cardiac patients undergoing coronary intervention. Study Design and Setting: Recalibration was assessed with the disease specific health-related quality of life (HRQL) instrument MacNew in combination with a then-test approach. Reconceptualisation and reprioritisation were assessed with the individualised QoL instrument SEIQoL-DW. Significant treatment effects were seen on the MacNew (global Δ: 0.6 ± 1.1, p = 0.004) but not on the SEIQoL-DW (Δ: 3.3 ± 16, p = 0.37) 6 months after coronary intervention. No recalibration effect was found on the MacNew then-test, while with the SEIQOL-DW potential response shift effects of reconceptualisation and reprioritisation were seen. For the first time response shift effects were explored in cardiac patients undergoing coronary intervention. This study confirmed that there is a clinically significant improvement in disease specific HRQL over time following successful coronary interventions. However, no treatment effect was seen for individualised QoL with the SEIQoL-DW. This might be due to reconceptualisation and reprioritisation response effects. Future studies need to focus on exploring response shift effects, and the interrelationship between its different components, captured by different patient reported outcome instruments in larger patient groups undergoing coronary interventions.     

Global interference and spatial uncertainty in the Sustained Attention to Response Task (SART)

The Sustained Attention to Response Task (SART) is a Go–No-Go signal detection task developed to measure lapses of sustained conscious attention. In this study, we examined the impact global interference and spatial uncertainty has on SART performance. Ten participants performed either a SART (high-Go) or a traditionally formatted (low-Go) version of a global–local stimuli detection task with spatially certain and uncertain signals. Reaction time in the SART was insensitive to global interference and spatial uncertainty, whereas reaction time in the low-Go task was sensitive. Spatial uncertainty increased errors of omission in the SART, which was not expected if the SART measures mindlessness. There was a high correlation between participants’ errors of commission rate and their reaction time in the SART. The results, overall, support the view that the SART is a better measure of response strategy than lapses in sustained attention or mindlessness.     

On the interplay between familiarity and emotional expression in face perception

Traditional models of face perception (e.g. Bruce and Young 1986) stress independent routes for processing identity and emotional expression. We investigated the interplay between familiarity and emotional expression by systematically varying both factors. In contrast to earlier studies which used binary forced-choice decisions, participants had to judge the familiarity of the presented face and the emotional hedonic valence and emotional arousal of its expressed emotion (angry, happy or neutral), using rating scales. The results demonstrated symmetric, strong interactions between familiarity and expressed emotion. Thus, this study supports more recent models of face perception (Haxby et al. 2000) that were mostly based on brain imaging data. These data together with our behavioural results emphasize the interaction of emotional expression and personal identity and support approaches that propose a relative segregation of these processes, rather than completely independent coding (Calder and Young 2005).     

Reasoning about cooperation,actions and preferences

In this paper, a logic for reasoning about coalitional power is developed which explicitly represents agents’ preferences and the actions by which the agents can achieve certain results. A complete axiomatization is given and its satisfiability problem is shown to be decidable and EXPTIME-hard.