A pilot study of the DBT coach: an interactive mobile phone application for individuals with borderline personality disorder and substance use disorder

Dialectical behavior therapy (DBT) has received strong empirical support and is practiced widely as a treatment for borderline personality disorder (BPD) and BPD with comorbid substance use disorders (BPD-SUD). Therapeutic success in DBT requires that individuals generalize newly acquired skills to their natural environment. However, there have been only a limited number of options available to achieve this end. The primary goal of this research was to develop and test the feasibility of the DBT Coach, a software application for a smartphone, designed specifically to enhance generalization of a specific DBT skill (opposite action) among individuals with BPD-SUD. We conducted a quasiexperimental study in which 22 individuals who were enrolled in DBT treatment programs received a smartphone with the DBT Coach for 10 to 14 days and were instructed to use it as needed. Participants used the DBT Coach an average of nearly 15 times and gave high ratings of helpfulness and usability. Results indicate that both emotion intensity and urges to use substances significantly decreased within each coaching session. Furthermore, over the trial period, participants reported a decrease in depression and general distress. Mobile technology offering in vivo skills coaching may be a useful tool for reducing urges to use substances and engage in other maladaptive behavior by directly teaching and coaching in alternative, adaptive coping behavior.     

Unique roles of antisocial personality disorder and psychopathic traits in distress tolerance

Previous research indicates that individuals with antisocial personality disorder (ASPD) evidence low distress tolerance, which signifies impaired ability to persist in goal-directed behavior during an aversive situation, and is associated with a variety of poor interpersonal and drug use outcomes. Based on theory and research indicating that psychopathic traits are associated with hypo-reactivity in emotional responding, a unique hypothesis emerges where psychopathic traits should have the opposite effect of ASPD and be related to high levels of distress tolerance. In a sample of 107 substance-dependent patients in an inner-city substance use residential treatment facility, this hypothesis was supported. ASPD was related to lower distress tolerance, while psychopathic traits were related to higher distress tolerance, with each contributing unique variance. Findings are discussed in relation to different presentations of distress tolerance as a function of psychopathic traits among those with an ASPD diagnosis.     

Trajectories of emotional well-being in mothers of adolescents and adults with autism

Raising an adolescent or adult child with a developmental disability confers exceptional caregiving challenges on parents. We examined trajectories of 2 indicators of emotional well-being (depressive symptoms and anxiety) in a sample of primarily Caucasian mothers (N = 379; M age = 51.22 years at Time 1) of adolescent and adult children with an autism spectrum disorder (ASD; M age = 21.91 years at Time 1, 73.2% male). We also investigated within-person associations of child context time-varying covariates (autism symptoms, behavior problems, residential status) and maternal context time-varying covariates (social support network size and stressful family events) with the trajectories of emotional well-being. Data were collected on 5 occasions across a 10-year period. Average patterns of stable (depressive symptoms) and improved (anxiety) emotional well-being were evident, and well-being trajectories were sensitive to fluctuations in both child and maternal context variables. On occasions when behavior problems were higher, depressive symptoms and anxiety were higher. On occasions after which the grown child moved out of the family home, anxiety was lower. Anxiety was higher on occasions when social support networks were smaller and when more stressful life events were experienced. These results have implications for midlife and aging families of children with an ASD and those who provide services to these families.     

Understanding Applicant Reactions to Credit Checks: Uncertainty,information effects and individual differences

Credit checks are an increasingly common selection procedure for American jobs, and they are distinct in a number of ways from the selection tests typically studied by researchers. With a credit check, applicants do not actually take a test or answer questions, and most will be uncertain about what information a credit report contains, why one is being requested, and how it will be evaluated. In two experiments we assess the effects of explanations and individual differences. Experiment 1 used a sample of 408 undergraduate business students to examine reaction dimensions relevant to credit checks, and found perceptions to be mainly negative. The type of explanation read, however, interacted with perceived credit report impact to influence reactions. Results of Experiment 2 , with a sample of students from a more non‐traditional population, were similar, but age was associated with greater skepticism of credit report accuracy. Privacy perceptions were the strongest predictor of intention to withdraw from the selection process.     

Therapist Response to Clients’ Partner Abuse: Implications for Training and Development of Marriage and Family Therapists

This qualitative study explored ecosystemic influences on therapists’ responses to partner abuse. Research questions focus on aspects of personal and professional development of attitudes and belief systems surrounding partner abuse. In-depth interviews with seven therapy trainees indicate that family of origin experiences, clinical experiences, and therapist developmental processes affect values, beliefs, and clinical reactivity to cases involving partner abuse. Implications for therapists’ self-work, clinical training, and the process of supervision are addressed.     

Spirituality and Counselor Competence: A National Survey of American Counseling Association Members

A random sample of 505 American Counseling Association (ACA) members completed a questionnaire that evaluated respondents' ratings of the importance of 9 competencies developed at the Summit on Spirituality (G. Miller, 1999; “Summit Results,” 1995) meetings to effectively address spiritual and religious issues in counseling practice. Results suggest that, in general, ACA members strongly support the importance of the competencies for effective counseling practice.     

Siblings of individuals with autism spectrum disorders across the life course

In this article, we review the literature on siblings of individuals with autism spectrum disorders (ASD) from a lifespan developmental perspective, from infancy through adulthood, focusing on the sibling relationship and sibling well-being. We situate this review within the larger body of research on siblings of individuals with developmental disabilities (DD) across the lifespan. We then consider the genetic aspects of ASDs and their implications for siblings. We conclude that there is an evidence of atypical social and communication development in some siblings of children with an ASD during infancy. During childhood and adolescence, siblings describe both positive and negative aspects of their sibling relationship and there is some evidence that siblings of children with an ASD may be at heightened risk for social and behavioral adjustment problems. The limited research on adulthood suggests that lack of closeness in the sibling relationship and social and emotional difficulties may continue. We encourage more attention focused on developmental issues, specifically with respect to samples in narrower age groups and in longitudinal research. Finally, we note the variability in sibling outcomes, and suggest further examination of potential moderating and mediating factors, including genetic predispositions.     

Feasibility of Using Video to Teach a Dialectical Behavior Therapy Skill to Clients With Borderline Personality Disorder

This study tested the feasibility of using a psychoeducational video recording to teach a behavioral skill from the Dialectical Behavior Therapy (DBT; Linehan, 1993a, 1993b) skills training program to individuals meeting criteria for borderline personality disorder. A video presenting a DBT emotion-regulation skill was developed and the extent to which viewers learned the skill material was evaluated via a randomized controlled trial (RCT), utilizing a within-subjects design. Thirty individuals meeting DSM-IV criteria for borderline personality disorder participated. Participants were recruited from mental health treatment settings and were naïve to DBT. Viewing the video was associated with significant increases in knowledge of the skill, relative to viewing a control video, and with increases in participants' expectations of positive outcomes for skill use. In addition, participants rated the video as relevant and helpful. A remarkably high number (80%) utilized the skill taught subsequent to viewing the video when assigned to do so, and overall reported significant decreases in negative affect after using the skill. Video appears to be feasible as a medium for teaching DBT skills material under controlled conditions; future research is needed to examine the effectiveness of video in more naturalistic settings.     

Modeling individual differences in working memory performance: a source activation account

Working memory resources are needed for processing and maintenance of information during cognitive tasks. Many models have been developed to capture the effects of limited working memory resources on performance. However, most of these models do not account for the finding that different individuals show different sensitivities to working memory demands, and none of the models predicts individual subjects' patterns of performance. We propose a computational model that accounts for differences in working memory capacity in terms of a quantity called source activation , which is used to maintain goal-relevant information in an available state. We apply this model to capture the working memory effects of individual subjects at a fine level of detail across two experiments. This, we argue, strengthens the interpretation of source activation as working memory capacity.