Delivery of Psychological Interventions by Clinical Neuropsychologists: Current Practice in Australia and Implications for Training

Clinical neuropsychologists are increasingly involved in delivering psychological interventions to people with neurological conditions. This is a key competency for accredited Australian postgraduate neuropsychology courses; however it is not clear how effective courses are in preparing neuropsychologists to deliver interventions. The study aims were to (a) determine the frequency and confidence with which particular types of interventions are delivered by Australian neuropsychologists, (b) examine the availability of opportunities to deliver interventions on clinical placements, (c) identify barriers to delivering interventions in current workplaces; and (d) determine which factors influence the frequency and confidence with which neuropsychologists deliver interventions. An online survey was completed by 114 participants who had graduated from a postgraduate neuropsychology program. Results indicated that respondents delivered different intervention types with varying frequency. They reported limited opportunities to practice these interventions on placements. The majority wanted to be doing more interventions, with lack of time, resources, and adequate training being the major barriers. There were several significant relationships between the frequency and confidence with which respondents delivered interventions and the perceived quality of their postgraduate training. These results highlight the need to consider appropriate postgraduate training options in delivery of interventions, including increasing opportunities to practice interventions on placements.     

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.     

Letting Go: Conceptualizing Intervention De‐implementation in Public Health and Social Service Settings

The discontinuation of interventions that should be stopped, or de‐implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de‐implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de‐implemented. We identify three criteria for identifying interventions appropriate for de‐implementation: (a) interventions that are not effective or harmful, (b) interventions that are not the most effective or efficient to provide, and (c) interventions that are no longer necessary. Detailed, well‐documented examples illustrate each of the criteria. We describe de‐implementation frameworks, but also demonstrate how other existing implementation frameworks might be applied to de‐implementation research as a supplement. Finally, we conclude with a discussion of de‐implementation in the context of other stages of implementation, like sustainability and adoption; next steps for de‐implementation research, especially identifying interventions appropriate for de‐implementation in a systematic manner; and highlight special ethical considerations to advance the field of de‐implementation research.     

Back to “the Future”: Evidence of a Bifactor Solution for Scores on the Consideration of Future Consequences Scale

Despite its widespread use, disagreement remains regarding the structure of the Consideration of Future Consequences Scale (CFCS). In particular there is disagreement regarding whether the scale assesses future orientation as a unidimensional or multidimensional (immediate and future) construct. Using 2 samples of high school students in the United Kingdom, 4 models were tested. The totality of results including item loadings, goodness-of-fit indexes, and reliability estimates all supported the bifactor model, suggesting that the 2 hypothesized factors are better understood as grouping or method factors rather than as representative of latent constructs. Accordingly this study supports the unidimensionality of the CFCS and the scoring of all 12 items to produce a global future orientation score. Researchers intending to use the CFCS, and those with existing data, are encouraged to examine a bifactor solution for the scale.     

Popularity, social acceptance, and aggression in adolescent peer groups: links with academic performance and school attendance

This article reports a short-term longitudinal study focusing on popularity and social acceptance as predictors of academic engagement for a sample of 342 adolescents (approximate average age of 14). These youths were followed for 4 consecutive semesters. Popularity, social acceptance, and aggression were assessed with a peer nomination inventory, and data on academic engagement were obtained from school records. For adolescents who were highly aggressive, increases in popularity were associated with increases in unexplained absences and decreases in grade point average. Conversely, changes in social acceptance were not predictive of changes in grade point average or unexplained absences. These results highlight the importance of multidimensional conceptualizations of social standing for research on school adjustment during adolescence and emphasize the potential risks associated with popularity.     

Stigma as ego depletion: how being the target of prejudice affects self-control

This research examined whether stigma diminishes people's ability to control their behaviors. Because coping with stigma requires self-regulation, and self-regulation is a limited-capacity resource, we predicted that individuals belonging to stigmatized groups are less able to regulate their own behavior when they become conscious of their stigmatizing status or enter threatening environments. Study 1 uncovered a correlation between stigma sensitivity and self-regulation; the more Black college students were sensitive to prejudice, the less self-control they reported having. By experimentally activating stigma, Studies 2 and 3 provided causal evidence for stigma's ego-depleting qualities: When their stigma was activated, stigmatized participants (Black students and females) showed impaired self-control in two very different domains (attentional and physical self-regulation). These results suggest that (a) stigma is ego depleting and (b) coping with it can weaken the ability to control and regulate one's behaviors in domains unrelated to the stigma.     

Disgust vulnerability and symptoms of contamination-based OCD: descriptive tests of incremental specificity

The present investigation examines the incremental association between disgust propensity and sensitivity and contamination-based obsessive-compulsive disorder (OCD) symptoms. Structural equation modeling in Study 1 indicated that general disgust was related to contamination fear even when controlling for negative affect in a nonclinical sample. Evidence was also found for a model in which the effect of negative affect on contamination fear is mediated by general disgust. Study 1 also showed that both disgust sensitivity and disgust propensity uniquely predicted contamination fear when controlling for negative affect. Growth curve analyses in Study 2 indicated that higher baseline contamination fear is associated with less reduction in contamination fear over a 6-week period as disgust sensitivity increases even when controlling for negative affect. Lastly, disgust propensity was associated with concurrent levels of excessive washing symptoms among patients with OCD in Study 3 when controlling for depression. Implications of these findings from nonclinical, analogue, and clinical samples for future research on the specificity of disgust-related vulnerabilities in the etiology of contamination concerns in OCD are discussed.     

Two-and-a-Half-Year-Olds’ Memory for Sources of Actions: Contextual Support Facilitates Recall

This research examines the early emergence of source-monitoring abilities. Previous research has consistently demonstrated that children as young as 3 to 4 years of age do well on simple versions of action-based source-monitoring tasks. Research on even younger children, however, remains lacking. In this study we examined whether 2½-year-olds could accurately recall source on a simplified task. For the procedure, we used an action-based task in which children collaborate with an experimenter to build a model farm. During construction, the child and the experimenter took turns placing items on the farm. After construction, children were administered a source memory test in which they were asked to recall who had placed each item. To more closely examine factors that influence source accuracy in this young population, we included two conditions that varied in terms of contextual support. In the no-context-cues condition, in line with typical source-monitoring tasks, children were asked the source test question while items were presented individually and the farm was not in view. In the context-cues condition, the original spatial array of farm items was left intact to provide additional cues for children's source decisions. The main finding was that children in both conditions showed high levels of source accuracy at test indicating a surprisingly early age of emergence for this ability. Also, as predicted, children in the context-cues condition were the most accurate in attributing source.     

The Yale-Brown Obsessive-Compulsive Scale: Confirmatory Factor Analytic Findings

The psychometric properties of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) have recently been heavily examined. Specifically, a number of researchers have been interested in determining the factor structure of this scale to find whether it best forms a one, two, or three factor model. The present study continued this examination by considering different scaling models using confirmatory factor analysis with a sample of individuals diagnosed with Obsessive-Compulsive Disorder (OCD). One hundred and forty-six individuals diagnosed with OCD participated and were administered the Y-BOCS and scales measuring depression (Hamilton Depression Rating Scale) and anxiety (Hamilton Anxiety Rating Scale). It was found that the Y-BOCS forms two different two-factor models. One model consisted of an obsessions and compulsions factor; the other composed of disturbance and symptom severity factors. It was likewise found that depression and anxiety were related to both factors in one model (disturbance and symptom severity). The finding that depression was related to obsessions and anxiety to compulsions was found, as in a previous factor analysis of the Y-BOCS. These findings suggest that OCD may be best characterized as a multidimensional syndrome that may not be adequately examined by a single unitary factor as described in the Y-BOCS.