Telephone-Administered Cognitive Behavioral Therapy: A Case Study of Anxiety and Depression in Parkinson’s Disease

Parkinson’s disease (PD) is a chronic medical illness with a high incidence of psychiatric comorbidity, specifically depression and anxiety. Research on treatment of such psychiatric complications is scarce. Non-pharmaceutical treatment options are especially attractive. Cognitive behavioral therapy (CBT) is a psychotherapeutic treatment option that has been successful in other chronically medically ill populations with comorbid depression and anxiety. The current research had two aims. The first was to pilot the feasibility of screening and identifying PD patients with symptoms of anxiety and depression in a specialized outpatient clinic. The second aim was to pilot the feasibility of telephone-administered CBT for the treatment of depression and anxiety in persons with PD, which was done through a case series comparing telephone-administered CBT to a Support strategy. A fairly large portion (67.5%) of patients screened in the outpatient clinic were identified as having symptoms of anxiety and/or depression. Results also indicated that CBT delivered via the telephone is a useful approach for targeting psychiatric symptoms in this population. A case example is given to illustrate the clinical considerations associated with delivering therapy via telephone to persons with PD. This study was conducted at the Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX. The first author was previously affiliated with the Houston Center for Quality of Care and Utilization Studies.     

Cognitive-Behavioral Therapy: Innovations for Cardiopulmonary Patients With Depression and Anxiety

Medically ill patients face unique physical and emotional challenges that place them at increased risk for symptoms of depression and anxiety. Despite high prevalence and significant impact, depression and anxiety are infrequently treated in the medically ill because of a variety of patient, provider, and system factors. The current article describes the development of an innovative, modular-based cognitive-behavioral intervention (Adjusting to Chronic Conditions Using Education Support and Skills [ACCESS]) that integrates treatment for symptoms of anxiety and depression with medical disease self-management in patients with heart failure and chronic obstructive pulmonary disease. Data from 3 patients who participated in an ongoing open clinical trial are reviewed to illustrate the feasibility, acceptability, and potential strengths and limitations of this intervention.     

Sex, Lies, and Video Games: The Portrayal of Male and Female Characters on Video Game Covers

Two hundred twenty-five console video game covers obtained from online retail sites were examined for portrayals of men and women. We hypothesized that males would be portrayed more often, but that females would be portrayed in a more hyper-sexualized manner. Male characters were almost four times more frequently portrayed than female characters and were given significantly more game relevant action. However, in spite of their less frequent appearance, female characters were more likely to be portrayed with exaggerated, and often objectified, sexiness. Further, violence and sexiness was paired more frequently for female characters than violence and muscular physiques for the male characters. The potential influence these negative portrayals could have on gamers is discussed.     

The dynamics and validity of the group selection interview

The authors examined the validity of the group interview, in which several applicants are interviewed simultaneously, vs. the traditional 1-on-1 selection interview. The authors also investigated perceptions of fairness for each interview format and whether the order in which the applicant was asked to respond in the group interview affected the quality of his or her response. Participants were 91 undergraduates who participated in 1-on-1 or group interviews for a scholarship award. The present results supported the hypothesis that interviewers in the 1-on-1 format were significantly better at predicting the applicants' academic potential. Also, in the group interviews, the order in which the applicants were asked to respond affected the quality of their responses significantly.     

Can it Ever Be Better Never to Have Existed At All? Person‐Based Consequentialism and a New Repugnant Conclusion

Broome and others have argued that it makes no sense, or at least that it cannot be true, to say that it is better for a given person that he or she exist than not. That argument can be understood to suggest that, likewise, it makes no sense, or at least that it cannot be true, to say that it is worse for a given person that he or she exist than that he or she never have existed at all. This argument is of critical importance to the question of whether consequentialist theory should take a traditional, aggregative form or a less conventional, person-affecting, or person-based form. I believe that, potentially, the argument represents a far more serious threat to the person-based approach than does, for example, Parfit's two medical programmes example. Parfit's example nicely illuminates the distinction between aggregative and person-based approaches and raises important questions. But the example--though not, I think, by Parfit--is sometimes pressed into service as a full-fledged counterexample against the person-based approach. As such, I argue, the example is not persuasive. In contrast, the Broomeian argument, if correct, is definitive. For that argument relies on certain metaphysical assumptions and various uncontroversial normative claims--and hence nicely avoids putting into play the controversial normative claims that lie at the very heart of the debate. The purpose of the present paper, then, is to evaluate the Broomeian argument. I argue that this potentially definitive challenge to a person-based approach does not in fact succeed.     

Test-retest reliability of standard and emotional stroop tasks: an investigation of color-word and picture-word versions

Previous studies have examined the reliability of scores derived from various Stroop tasks. However, few studies have compared reliability of more recently developed Stroop variants such as emotional Stroop tasks to standard versions of the Stroop. The current study developed four different single-stimulus Stroop tasks and compared test-retest reliabilities. The four Stroop tasks included two standard Stroop tasks (color-word and picture-word) as well as two emotional Stroop tasks (color-word and picture-word). The four Stroop tasks were administered on two occasions, separated by 1 week, to 28 undergraduate students. Test-retest reliability coefficients were high for standard and emotional Stroop tasks when reliability was measured using response latencies alone. However, test-retest coefficients were unacceptably low when reliability estimates were calculated using difference scores. The findings have important implications for clinical and experimental use of standard and emotional Stroop tasks.     

Engagement in Behavioral Parent Training: Review of the Literature and Implications for Practice

Engagement in behavioral parent training (BPT), including enrollment, attrition, attendance, within-session engagement, and homework completion, has long been a critical issue in the literature. Several estimates of various aspects of engagement have been suggested in the literature, but a systematic review of the available literature has never been accomplished. This review examines engagement data across 262 studies of BPT. Recruitment attrition, program attrition, attendance, and within-session engagement are examined across studies, with particular emphasis on the impact that SES, study purpose (efficacy vs. effectiveness), treatment format (individual vs. group), and age of child may have on those rates. Results of this review suggest that the significant amount of attrition occurs prior to enrollment in BPT, with at least 25 % of those identified as appropriate for BPT not enrolling in such programs. An additional 26 % begin, but drop out before completing treatment. Still the combined dropout rate of at least 51 % leaves at best half of identified parents completing treatment. While SES status had a small effect on attrition, other variables were not found to meaningfully impact engagement. Information on within-session engagement (homework and ratings of participation) was not often reported in studies. Key issues in this literature (e.g., varying definitions of engagement, limited attention to reporting key aspects of engagement) are discussed, and recommendations are made to further improve this important area of research and clinical practice.     

Virtual Empathy? Anxieties and Connections Teaching and Learning Pastoral Care Online

Is it possible to teach pastoral care online? McGarrah Sharp and Morris describe their process of transforming a residential on‐campus pastoral care course into the first online offering of the course at their seminary. They begin by describing a series of pedagogical choices made with the intent of facilitating dynamic movement between peer‐to‐peer, small group, and whole class discussions throughout the semester. Before and during the course, anxieties arose at many levels of instruction for the professor, teaching assistant, and students. Anecdotes and examples from the online course show how the online course design and facilitation was able to name and respond to anxieties as part of integrating pastoral care course content and practice – a key learning goal for the course. The authors are persuaded that online pedagogy can help identify how anxieties create space for developing empathy as much, if not more than, a traditional on‐campus format.     

Reflective minds and open hearts: Cognitive style and personality predict religiosity and spiritual thinking in a community sample

We examined associations between two psychological constructs, analytic cognitive style and the personality facet ‘Openness to Experience’, and several dimensions of religiosity: religious affiliation, strength of faith and spiritual epistemology. In a relatively large (N = 1093), older community sample (M = 55.4 years), analytic cognitive style was associated with a lower probability of affiliating with a religious denomination and a higher probability of possessing strong religious faith. Overall, openness was also associated with a lack of religious affiliation but was positively related to possessing a spiritual epistemology. A path‐analytic model revealed that openness had a positive relationship to both faith and religious denomination that was mediated by spiritual epistemology, but negative direct relationships with religiosity after the meditational effects were taken into account. Taken together, these results extend previous findings on the effect of cognitive style on religiosity and provide a new perspective on the complex relationship between cognitive and personality factors and different dimensions of religiosity. Copyright © 2014 John Wiley & Sons, Ltd.     

Post Traumatic Stress,Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth

This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n = 191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD symptoms did not significantly decline over time and were higher than rates reported at earlier time points for more ethnically diverse samples. Younger age, female sex, and continued disrepair to the child’s home predicted stable elevated PTSD symptoms. Findings are consistent with predictions from contextual theories of disaster exposure and with epidemiological data from adult samples suggesting that the incidence of PTSD post Katrina is showing an atypical pattern of remittance. Theoretical, applied, and policy implications are discussed.