Improving Delivery Behaviors During Exposure for Pediatric OCD: A Multiple Baseline Training Trial With Community Therapists

This study tested whether a new training tool, the Exposure Guide (EG), improved in-session therapist behaviors (i.e., indicators of quality) that have been associated with youth outcomes in prior clinical trials of exposure therapy. Six therapists at a community mental health agency (CMHA) provided exposure therapy for 8 youth with obsessive–compulsive disorder (OCD). Using a nonconcurrent multiple baseline design with random assignment to baseline lengths of 6 to 16 weeks, therapists received gold-standard exposure therapy training with weekly consultation (baseline phase) followed by addition of EG training and feedback (intervention phase). The primary outcome was therapist behavior during in-session exposures, observed weekly using a validated coding system. Therapist behavior was evaluated in relation to a priori benchmarks derived from clinical trials. Additional outcomes included training feasibility/acceptability, therapist response to case vignettes and beliefs about exposure, and independent evaluator-rated clinical outcomes. Three therapists reached behavior benchmarks only during the EG (intervention) phase. Two therapists met benchmarks during the baseline phase; one of these subsequently moved away from benchmarks but met them again after starting the EG phase. Across all therapists, the percentage of weeks meeting benchmarks was significantly higher during the EG phase (86.4%) vs. the baseline phase (53.2%). Youth participants experienced significant improvement in OCD symptoms and global illness severity from pre- to posttreatment. Results provide initial evidence that adding the EG to gold-standard training can change in-session therapist behaviors in a CMHA setting.     

Toward a More Credible Understanding of Post-Traumatic Growth

Traditional research on post-traumatic growth has utilized methodologically flawed cross-sectional designs that involve retrospective assessments of post-traumatic growth. This has resulted in a majority of research in this field suffering from a lack of credibility and reliability. In this special issue, we present nine articles that seek to make innovative conceptual and methodological contributions with the goal of promoting better research practices on post-traumatic growth. In the introduction to this special issue, we provide an overview of these contributions, and discuss the implications of these articles both to improving future scholarship and to encouraging personality scientists to examine this important phenomenon in the years and decades to come.     

Bidirectional Links Between Teachers’ Disciplinary Practices,Students’ Peer Status,and Students’ Aggression in Kindergarten

Research on Child and Adolescent Psychopathology - This study examined bidirectional links between teachers’ disciplinary practices (punitive and educational), students’ peer status in...     

Is Evidence Normative?

Philosophia - This paper defends the view that in a certain sense evidence is normative. Neither a bit of evidence nor the fact that it is evidence for a certain proposition is a normative fact,...     

Elevation and reduction of plasma tryptophan and their effects on aggression and perceptual sensitivity in normal males

Data from experimental animals suggest that 5-hydroxytryptamine (5HT) may have an inhibitory effect on aggression, while clinical studies have found a correlation between pathological aggression and low brain 5HT. To investigate this relationship further we used amino acid mixtures designed to raise or lower the levels of the 5HT precursor, tryptophan. Normal male subjects were given tryptophan-depleted, balanced, or tryptophan-supplemented ammo acid mixtures and tested for aggression 5 hours later. The balanced amino acid mixture served as a control for the tryptophan depletion and supplementation. Testing for aggression was done using the Buss paradigm in which subjects deliver electric shocks to a (nonexistent) partner in response to stimulus tones. Duration and intensity of shock delivered were the measures of aggression, while responsivity to the stimulus tones was the measure of perceptual sensitivity. Neither tryptophan supplementation nor tryptophan depletion had any effect on these measures of aggression or perceptual sensitivity. We conclude that raising or lowering the synthesis of brain 5HT through alterations in tryptophan availability does not influence aggression in normal males as measured by the Buss task.