The Counseling Center Assessment of Psychological Symptoms Distress Index: A pragmatic exploration of general factors to enhance a multidimensional scale

Objective: The authors attempted to develop and validate a general distress index for a multidimensional psychological symptom/outcome measure used in over 300 college counseling centers with more than 100,000 cases annually: the Counseling Center Assessment of Psychological Symptoms (CCAPS). Method: Four models were compared for fit indices (n = 19,247): the existing first-order factor model (without a general factor), a second-order factor model, a bifactor model, and a single factor or “total score” model. In separate clinical and non-clinical samples, concurrent and divergent validity were examined using several well-established measures of psychological symptoms, as well as two-week test–retest and treatment utilization data. Results: Second-order and bifactor models which captured a single “distress” factor both exhibited good fit to the data relative to the baseline and “total score” model. Validity data indicated that factors adequately measured meaningful clinical onstructs. Conclusion: Both the bifactor and second-order models indicated the presence of a “distress index” comprised items across many of the CCAPS subscales. This distress scale has strong applicability for benchmarking the overall severity and complexity of patients at different centers, and can be used to help identify colleges and universities with areas of clinical strength, which can be studied to improve the field. Clinically, the distress index offers a parsimonious and efficient method for clinicians to monitor patients’ progress through treatment.     

Fehldiagnose Aufmerksamkeitsdefizit- und Hyperaktivit?tssyndrom?

Although it is assumed both by healthcare professionals as well as by public opinion that attention deficit hyperactivity disorder (ADHD) is widely overdiagnosed, so far there is little empirical evidence to support this presumption. However, the presented study shows clear evidence for an overdiagnosis of ADHD. Furthermore, the data demonstrate that based on identical symptoms, boys more often receive a diagnosis for ADHD than girls. A false ADHD diagnosis also correlates with a recommendation for medical and psychotherapeutic treatment. One explanation for misdiagnosis is the fact that therapists in the course of diagnosis, as with other everyday decision-making processes, are influenced by heuristics. The most common heuristics that can lead to misdiagnosis are the representativeness heuristic and the availability heuristic. Such mistakes could be avoided by clearly following diagnostic criteria and the use of structural interviews.     

Cognitive Load Disrupts Implicit Theory-of-Mind Processing

Eye movements in Sally-Anne false-belief tasks appear to reflect the ability to implicitly monitor the mental states of other individuals (theory of mind, or ToM). It has recently been proposed that an early-developing, efficient, and automatically operating ToM system subserves this ability. Surprisingly absent from the literature, however, is an empirical test of the influence of domain-general executive processing resources on this implicit ToM system. In the study reported here, a dual-task method was employed to investigate the impact of executive load on eye movements in an implicit Sally-Anne false-belief task. Under no-load conditions, adult participants displayed eye movement behavior consistent with implicit belief processing, whereas evidence for belief processing was absent for participants under cognitive load. These findings indicate that the cognitive system responsible for implicitly tracking beliefs draws at least minimally on executive processing resources. Thus, even the most low-level processing of beliefs appears to reflect a capacity-limited operation.     

Assessment of Attention in Preschoolers

In the past two decades, there has been an increased interest in the assessment and treatment of preschool children presenting with concerns about attention problems. This article reviews the research and clinical literature involving assessment of attention and related skills in the preschool years. While inattention among preschoolers is common, symptoms alone do not necessarily indicate a disorder, and most often represent a normal variation in typical preschool child development. Thus, accurate identification of ??disordered?? attention in preschoolers can be challenging, and development of appropriate, norm-referenced tests of attention for preschoolers is also difficult. The current review suggests that comprehensive assessment of attention and related functions in the preschool child should include thorough review of the child??s history, planned observations, and formal psychometric testing. The three primary methods of psychometric assessment that have been used to characterize attentional functioning in preschool children include performance-based tests, structured caregiver interviews, and rating scales (parent, teacher, and clinician). Among performance-based methods for measurement of attention in the preschool years, tests have been developed to assess sustained attention, selective (focused) attention, span of attention (encoding/manipulation), and (top-down) controlled attention??including freedom from distractibility and set shifting. Many of these tests remain experimental in nature, and review of published methods yields relatively few commercially available, nationally normed tests of attention for preschoolers, and an overall dearth of reliability and validity studies on the available measures.     

Eye movements reveal sustained implicit processing of others' mental states

The ability to attribute mental states to others is crucial for social competency. To assess mentalizing abilities, in false-belief tasks participants attempt to identify an actor's belief about an object's location as opposed to the object's actual location. Passing this test on explicit measures is typically achieved by 4 years of age, but recent eye movement studies reveal registration of others' beliefs by 7 to 15 months. Consequently, a 2-path mentalizing system has been proposed, consisting of a late developing, cognitively demanding component and an early developing, implicit/automatic component. To date, investigations on the implicit system have been based on single-trial experiments only or have not examined how it operates across time. In addition, no study has examined the extent to which participants are conscious of the belief states of others during these tasks. Thus, the existence of a distinct implicit mentalizing system is yet to be demonstrated definitively. Here we show that adults engaged in a primary unrelated task display eye movement patterns consistent with mental state attributions across a sustained temporal period. Debriefing supported the hypothesis that this mentalizing was implicit. It appears there indeed exists a distinct implicit mental state attribution system.     

Religious Experience in a Cross-Cultural and Interfaith Context: Limitations and Possibilities

Religious experience is a multifaceted aspect of an individual’s experience involving conscious and unconscious components. Individuals, for example, maintain varied ideas of God at different levels of awareness and consciousness, all of which contribute to their broader experience of God. This paper focuses primarily on complex theistic experiences of God, their relationship to psychological and spiritual health, and how these experiences can be changed through psychological intervention. Consideration is also given to ethical issues and other implications of changing one’s religious experience.     

Does the Vigilance-Avoidance Gazing Behavior of Children with Separation Anxiety Disorder Change after Cognitive-Behavioral Therapy?

Cognitive biases are of interest in understanding the development of anxiety disorders. They also play a significant role during psychotherapy, where cognitive biases are modified in order to break the vicious cycle responsible for maintaining anxiety disorders. In a previous study, the vigilance-avoidance pattern was shown in children with separation anxiety disorder (In-Albon et al. Journal of Abnormal Child Psychology 38:225-235, 2010). The exhibited avoidance pattern may be essential for the maintenance of the anxiety disorder. Therefore, in the present study we used eye tracking methodology presenting disorder specific pictures to examine possible changes in the vigilance-avoidance pattern in 18 children with separation anxiety disorder after cognitive-behavioral treatment (CBT) and 13 healthy controls. Results indicated that following treatment, the vigilance pattern of children with separation anxiety disorder reduced significantly. Thus, the vigilance-avoidance pattern can be modified by CBT.