The Impact of Couple Therapy on Service Utilization among Military Veterans: The Moderating Roles of Pretreatment Service Utilization and Premature Termination

Couple therapy reduces relational and individual distress and may affect utilization of other health services, particularly among higher service utilizers. Although average decreases in service utilization are predicted among recipients of couple therapy, low utilizers of services may appropriately increase use. The relationship between couple therapy and service utilization was examined among a sample of 179 U.S. military veterans who received treatment in Veterans Affairs (VA) specialty couple therapy clinics. Consistent with hypotheses, overall mental and physical health visits decreased from the 12 months preceding couple therapy to the 12 months following treatment. Moderator analyses showed that decreases were greatest among individuals who were rated by their therapist as having completed a full course of couple therapy, suggesting that change was attributable to intervention. Pretreatment service utilization also moderated observed change—higher utilizers’ use of services decreased substantially, whereas lower utilizers’ slightly increased. Cost analyses revealed that the estimated per person mean cost in our sample decreased by $930.33 in the year following compared to the year prior to couple therapy, as per 2008 VA cost data. As service utilization data were only available for one partner and only for 1 year posttherapy, the true magnitude of this effect may be underestimated. Our findings are relevant to policy makers as they demonstrate that couple therapy reduces average service utilization and associated costs and addresses calls for analyses of cost effectiveness of systemic interventions.     

On a Belief-Relative Moral Right to Civil Disobedience

Res Publica - Acts of civil disobedience are undertaken in defense of a variety of causes ranging from banning GMO crops and prohibiting abortion to fighting inequality and saving the environment....     

Retrospective recall of affect in clinically depressed individuals and controls

The current study examined the nature of retrospective recall of affect in depressed participants and nonclinical controls. Utilising the Experience Sampling Method, we compared average momentary affect reports to retrospective summaries of the same period of time. Both groups exhibited exaggerated retrospective summaries of positive affect (PA) and negative affect (NA). Greater bias for PA than NA was found in the controls but not the depressed. Across groups, depressed individuals exhibited more absolute inaccuracy in their recall of NA but not PA. For depressed and nonclinical individuals, retrospective summaries of PA were better predicted by an average of all weekly momentary PA than a combination of the most intense (“peak”) PA and most recent (“end”) PA experiences. For nonclinical participants, retrospective NA was better predicted by an average of all weekly momentary NA. For depressed individuals, however, no clear advantage to predicting retrospective NA by average weekly NA relative to a combination of peak NA and end NA was found. Based on our findings, clinicians should realise that depressive cognition may not lie in recall that is less positive and more negative than “reality” but in retrospective intensifications of all affect that are, compared to normal, relatively greater for negative than for positive affect.     

Test–Retest Reliability of the ECO Computerised Cognitive Battery for the Elderly

The current study presents the test–retest reliability data for the ECO (Examen Cognitif par Ordinateur) computerised cognitive battery developed by Ritchie et al. (1993). Repeat testings were conducted using a sample of 36 healthy elderly with normal cognitive functioning. Sixteen of the battery’s 23 subtests yielded significant correlation coefficients ranging from .42 to .90 (Pearson’s r). A mild practice effect was detected with two of the seven memory tests and two of the seven visuospatial tests (p <.05). Comments about the sources of measurement error and recommendations for further test development are made.     

Understanding communicative intentions and semiotic vehicles by children and chimpanzees

Developmental and comparative studies of the ability to understand communicative intentions using object-choice tasks raise questions concerning the semiotic properties of the communicative signals, and the roles of rearing histories, language and familiarity. We adapted a study by Tomasello, Call, and Gluckman (1997), in which a “helper” indicated the location of a hidden reward to children of three ages (18, 24, and 30 months) and to four chimpanzees, by means of one of four cues: Pointing, Marker, Picture and Replica. For the chimpanzees, we controlled for familiarity by using two helpers, one unfamiliar and one highly familiar. Even 18-months performed well on Pointing and Marker, while only the oldest group clearly succeeded with Picture and Replica. Performance did not correlate with scores for the Swedish Early Communicative Development Inventory (SECDI). While there were no positive results for the chimpanzees on the group level, and no effect of familiarity, two chimpanzees succeeded on Pointing and Marker. Results support proposals of a species difference in understanding communicative intentions, but also highlight the need to distinguish these from the complexity of semiotic vehicles and to consider both factors.     

Short-Term Suicide Awareness Curriculum

ABSTRACT: The present study attempted to determine the effectiveness of a suicide awareness curriculum and to assess two methods of presenting the information. It was hypothesized that students receiving instruction via lectures and handouts would score significantly higher than students who only received handouts. Dependent variables included the Suicide Intervention Response Inventory (SIRI), the Knowledge of Suicide Test (KOST), the Suicide Prevention Questionnaire (SPQ), and specific suicide-related vignettes. There was a significant main effect for treatment. Univariate analyses demonstrated significant treatment effects for all dependent measures. Two orthogonal contrasts demonstrated significant differences on the KOST and the vignettes, suggesting that the lectures were instrumental in the increased performance on those tasks.