Reevaluating Cue Exposure and Response Prevention in a Pilot Study: An Updated Treatment for Binge Eating Disorder

Approximately half of individuals with binge eating disorder (BED) fail to improve when treated with cognitive behavioral therapy; thus, better treatments are needed. Cue exposure and response prevention (CERP) may be one option, but its full potential for reducing binge eating remains unknown because prior applications for binge eating have not utilized the broad range of strategies believed to optimize exposure therapy. The current single-subject AB design investigated the acceptability and effectiveness of a comprehensive CERP treatment among 8 women who met DSM-5 criteria for binge eating disorder. Changes in the number of binges were measured from baseline to the end of treatment, and desire to eat, salivation, and idiographic expectancies of aversive outcomes to food-cue exposure (idiographic CS-US expectancies), including expectancies about ability to tolerate distress when exposed to food cues were measured across the course of treatment. Statistical analysis revealed a significant reduction in the number of binges from baseline to the end of treatment. Across the course of treatment, desire to eat and idiographic CS-US expectancies reduced, and distress tolerance expectancies increased. No participants dropped out and all reported being maximally satisfied with the treatment. Based on these findings, future randomized-control trials with larger samples should examine the efficacy of CERP and mechanisms underlying change with the aim of establishing a more effective treatment for binge eating disorder.     

The Empirical Status of Cue Exposure and Response Prevention Treatment for Binge Eating: A Systematic Review

Approximately 50% of individuals fail to obtain treatment benefits when undergoing cognitive-behavioral therapy (CBT) for binge-eating behaviors, making it necessary to evaluate additional approaches. Cue exposure and response prevention (CERP) is one such approach, although its effectiveness across studies has been inconsistent. This may be due to inconsistent implementation of theoretically based CERP strategies. This possibility has not yet been systematically investigated. To address this gap, this review investigated which CERP strategies have been incorporated into treatment protocols for binge eating, and if the use of certain strategies improves treatment effectiveness. Relevant studies were identified through reference lists, grey literature, and searches of electronic databases using multiple search terms related to CERP and binge eating, which resulted in 18 eligible studies. Most studies were underpowered, many were of low methodological quality, and none of the included studies utilized all of the strategies that have been recommended to optimize CERP. Despite these weaknesses, CERP appeared to reduce the frequency of binge eating in the short and long term. This review underscores the need for higher quality research that utilizes larger samples and uniform outcome measures that are more strongly grounded in theory. Such research would help improve treatment outcomes for binge eating.     

Implementing and Sustaining SHARE: An Exposure‐Based Psychotherapy Group for Incarcerated Women Survivors of Sexual Violence

Although incarcerated women are a highly victimized population, therapy for sexual violence victimization (SVV) sequela is not routinely offered in prison. SHARE is a group therapy for SVV survivors that was successfully implemented and sustained in a women’s correction center. Here, we aimed to identify implementation factors and strategies that led to SHARE’s success and describe incarcerated women’s perspectives on the program. We conducted a retrospective process evaluation using interviews structured according to EPIS, a well‐established implementation science framework. Participants (N = 22) were incarcerated women, members of the SHARE treatment team, and members of the correction center’s leadership, therapeutic team, and volunteer program. Factors that facilitated SHARE implementation varied by EPIS phase and organization. Positive inter‐organizational and interpersonal relationships were key across phases, as were the synergies between both the strengths and needs of each organization involved in implementation. Incarcerated women reported a strong need for SHARE and did not report any concerns about receiving trauma therapy in a carceral setting. Therapy for SVV sequelae, including exposure‐based therapy, is possible to implement and sustain in carceral settings. Community–academic partnerships may be a particularly feasible way to expand access to SVV therapy for incarcerated women.     

Evaluation of a statewide initiative to reduce expulsion of young children

This program evaluation study describes 3 years of implementation of Arkansas's BehaviorHelp (BH) system, a statewide expulsion prevention support system for early care and education (ECE). BH coordinates three tiers of supports to ECE professionals, including phone support, on‐site technical assistance (TA), and infant and early childhood mental health consultation (IECMHC). We examine differences in characteristics of those served across BH service tiers, describe short‐term case outcomes, and explore factors associated with expulsions. BH accepted referrals for 1,195 children in 488 ECE programs. The majority of referrals involved male children over the age of three, and most cases were assigned to the TA tier (68.5%). Cases assigned to receive IECMHC (28.4%) were more likely to involve children in foster care, receiving developmental therapies, and with higher rates of exposure to potentially traumatic events. The expulsion rate among referred children was 2.9%, and reported teacher engagement with the support process was high. Teachers receiving IECMHC services reported significant improvements in children's symptoms of emotional and behavioral problems. Exploratory analyses revealed that risk factors for expulsion included being a male, in foster care, in a lower quality ECE environment, and having a teacher with less training in social–emotional development.     

Nature,corruption, and freedom: Stoic ethics in Kant's Religion

Kant's account of “the radical evil in human nature” in the 1793 Religion within the Bounds of Reason Alone is typically interpreted as a reworking of the Augustinian doctrine of original sin. But Kant does not talk about Augustine explicitly there, and if he is rehabilitating the doctrine of original sin, the result is not obviously Augustinian. Instead, Kant talks about Stoic ethics in a pair of passages on either end of his account of radical evil and leaves other clues that his argument is a reworking of an old Stoic problem. “Radical evil” refers to the idea that our moral condition is—by default and yet by our own deed—bad or corrupt; and that this corruption is the root (radix) of human badness in all its variety, ubiquity, and sheer ordinariness. Kant takes as his premise a version of the Stoic idea that nature gives us “uncorrupted starting points” (Diogenes Laertius 7.89). What sense can be made of the origin of human badness, given such a premise? Kant's account of radical evil is an answer to this old Stoic problem, which requires a conception of freedom that is not available in his Stoic sources.     

Together We Rise: How Social Movements Succeed

Social movements, such as Black Lives Matter, surge when support grows for their social justice goals. At their core, social movements advance when people act collectively by rising in solidarity with a shared purpose to address injustice and inequality. Drawing on insights from consumer psychology, this review investigates how social movements succeed in creating social change. We build on an established 21^st‐century framework for how social movements succeed to outline the promising practices of successful social movements. For each of these practices, we identify the consumer psychology mechanisms that motivate collective action and encourage people to transform from bystanders to upstanders, those who provide the grassroots momentum for successful social movements. We illustrate this framework with examples from the growth of the Black Lives Matter movement. Finally, we highlight insights from consumer psychology that promote an understanding of social movements, and we raise research questions to encourage more consumer psychologists to investigate how social movements succeed.     

Personal Loss,Parental Relationships,and Caregiving Intentions among Adult Siblings of Individuals with Mental Illness

Journal of Child and Family Studies - Although parents often provide care for adult children coping with serious mental illness, adult siblings are typically expected to assume caregiving...     

Addicted to the Thrill of the Virtual Hunt: Examining the Effects of Internet Addiction on the Cyberstalking Behaviors of Juveniles

The rapid advancement of technology has produced several substantial benefits that enrich individuals’ lives, but some also note that technology has provided new methods to engage in crime—particularly stalking. This investigation was one of the first to explore whether a relationship existed between cyberstalking and a new phenomenon becoming a pressing issue in the lives of adolescents: Internet Addiction. High school students in a rural North Carolina country were surveyed about their Internet behaviors and experiences. After analysis, the results indicated there is a significant relationship between Internet Addiction and cyberstalking in adolescents.     

Using Symbolic-Experiential Family Therapy to Treat Adjustment Disorder: A Case Study

Despite studies claiming Adjustment Disorders (AD) affect up to 10% of the general population, research is severely lacking for effective treatment recommendations and screening tools. This article presents the treatment of a 30-year old Caucasian male diagnosed with AD - mixed anxiety and depression subtype. After 12 standard 60-minute sessions, treatment using a Symbolic-Experiential Family Therapy (SEFT) approach resulted in the alleviation of depression and anxiety symptoms. This case study provides preliminary evidence for the effectiveness of SEFT using a mixed methods case study. Implications for further study, and the usefulness of SEFT for the treatment of AD, is presented.