Cognitive-Behavioral Therapy in the Treatment of Internalizing Disorders in High-Functioning Youth with Autism Spectrum Disorder

Anxiety and depression are often comorbid with Autism Spectrum Disorder (ASD). There is empirical support to suggest that cognitive-behavioral therapy (CBT) is an efficacious treatment for comorbid anxiety disorders in youth with ASD. Modifications to CBT for youths with ASD have been made with emphasis on exposure being a critical component. Few studies have evaluated the efficacy of CBT on symptoms of depression in youths with ASD. Modifications to CBT will be outlined in this review, as will implementation suggestions for the clinician practicing CBT with ASD youth. Limitations of the studies investigating this intervention include small sample sizes, clinician- and parent-report of symptom change but not consistent self-identified change, limited validated tools for assessing change, and lack of long-term follow-up.     

Task difficulty modulates brain-behavior correlations in language production and cognitive control: Behavioral and fMRI evidence from a phonological go/no-go picture-naming paradigm

Language production and cognitive control are complex processes that involve distinct yet interacting brain networks. However, the extent to which these processes interact and their neural bases have not been thoroughly examined. Here, we investigated the neural and behavioral bases of language production and cognitive control via a phonological go/no-go picture-naming task. Naming difficulty and cognitive control demands (i.e., conflict monitoring and response inhibition) were manipulated by varying the proportion of naming trials (go trials) and inhibition trials (no-go trials) across task runs. The results demonstrated that as task demands increased, participants’ behavioral performance declined (i.e., longer reaction times on naming trials, more commission errors on inhibition trials) whereas brain activation generally increased. Increased activation was found not only within the language network but also in domain-general control regions. Additionally, right superior and inferior frontal and left supramarginal gyri were sensitive to increased task difficulty during both language production and response inhibition. We also found both positive and negative brain–behavior correlations. Most notably, increased activation in sensorimotor regions, such as precentral and postcentral gyri, was associated with better behavioral performance, in both successful picture naming and successful inhibition. Moreover, comparing the strength of correlations across conditions indicated that the brain–behavior correlations in sensorimotor regions that were associated with improved performance became stronger as task demands increased. Overall, our results suggest that cognitive control demands affect language production, and that successfully coping with increases in task difficulty relies on both language-specific and domain-general cognitive control regions.     

Coping and Positive Affect in Adolescents of Mothers With and Without a History of Depression

The adolescent children of depressed mothers are at increased risk for depression, but little is known about protective factors for these children. Maintenance of positive affect in a stressful context may be an important marker of resilience. Mothers with (n = 34) and without (n = 38) a history of depression and their adolescent children completed questionnaires regarding adolescents’ coping and depressive symptoms and engaged in a 15 min videotaped interaction about family stress. Adolescents’ observed behaviors were coded using the Iowa Family Interaction Rating Scales. No significant differences emerged in observed behavior between adolescents of mothers with and without a history of depression. Higher levels of primary and secondary control coping and lower levels of disengagement coping were related to higher levels of observed positive mood and fewer depressive symptoms in adolescents. Observed positive mood was related to fewer depressive symptoms in adolescents, even after accounting for maternal history of depression and current maternal depressive symptoms. Results suggest the importance of considering positive affect in the context of family stress as a marker of resilience in adolescents at risk for depression. The current study provides evidence for coping as a protective factor, related to higher levels of positive affect and fewer depressive symptoms, in adolescents exposed to maternal depressive symptoms.     

Testing a model of minority identity achievement, identity affirmation, and psychological well-being among ethnic minority and sexual minority individuals

How is social identity related to psychological well-being among minority individuals? Drawing on developmental models of identity formation (e.g., Erikson, 1968) and on Social Identity Theory (Tajfel & Turner, 1979), we tested a conceptual model examining links between two key aspects of social identity and psychological well-being. We proposed that the association between identity achievement (exploring and understanding the meaning of one's identity) and psychological well-being is mediated by identity affirmation (developing positive feelings and a sense of belonging to one's social group). Across three studies, including ethnic minority high school students (Study 1), ethnic minority college students (Study 2) and lesbian and gay male adults (Study 3), we found strong support for the model. Results suggest that the process of exploring and understanding one's minority identity can serve as an important basis for developing positive feelings toward and an enhanced sense of attachment to the group, which can in turn confer psychological benefits for minority individuals. Implications and directions for future research are discussed.     

Pupillary Stroop effects

We recorded the pupil diameters of participants performing the words’ color-naming Stroop task (i.e., naming the color of a word that names a color). Non-color words were used as baseline to firmly establish the effects of semantic relatedness induced by color word distractors. We replicated the classic Stroop effects of color congruency and color incongruency with pupillary diameter recordings: relative to non-color words, pupil diameters increased for color distractors that differed from color responses, while they reduced for color distractors that were identical to color responses. Analyses of the time courses of pupil responses revealed further differences between color-congruent and color-incongruent distractors, with the latter inducing a steep increase of pupil size and the former a relatively lower increase. Consistent with previous findings that have demonstrated that pupil size increases as task demands rise, the present results indicate that pupillometry is a robust measure of Stroop interference, and it represents a valuable addition to the cognitive scientist’s toolbox.     

Temporal associations and prior-list intrusions in free recall

When asked to recall the words from a just-presented target list, subjects occasionally recall words that were not on the list. These intrusions either appeared on earlier lists (prior-list intrusions, or PLIs) or had not appeared over the course of the experiment (extra-list intrusions). The authors examined the factors that elicit PLIs in free recall. A reanalysis of earlier studies revealed that PLIs tend to come from semantic associates as well as from recently studied lists, with the rate of PLIs decreasing sharply with list recency. The authors report 3 new experiments in which some items in a given list also appeared on earlier lists. Although repetition enhanced recall of list items, subjects were significantly more likely to make PLIs following the recall of repeated items, suggesting that temporal associations formed in earlier lists can induce recall errors. The authors interpret this finding as evidence for the interacting roles of associative and contextual retrieval processes in recall. Although contextual information helps to focus recall on words in the target list, it does not form an impermeable boundary between current- and prior-list experiences.     

Chronically increased Gsalpha signaling disrupts associative and spatial learning

The cAMP/PKA pathway plays a critical role in learning and memory systems in animals ranging from mice to Drosophila to Aplysia. Studies of olfactory learning in Drosophila suggest that altered expression of either positive or negative regulators of the cAMP/PKA signaling pathway beyond a certain optimum range may be deleterious. Here we provide genetic evidence of the behavioral and physiological effects of increased signaling through the cAMP/PKA pathway in mice. We have generated transgenic mice in which the expression of a constitutively active form of Gsalpha (Gsalpha* Q227L), the G protein that stimulates adenylyl cyclase activity, is driven in neurons within the forebrain by the promoter from the CaMKIIalpha gene. Despite significantly increased adenylyl cyclase activity, Gsalpha* transgenic mice exhibit PKA-dependent decreases in levels of cAMP due to a compensatory up-regulation in phosphodiesterase activity. Interestingly, Gsalpha* transgenic mice also exhibit enhanced basal synaptic transmission. Consistent with a role for the cAMP/PKA pathway in learning and memory, Gsalpha* transgenic mice show impairments in spatial learning in the Morris water maze and in contextual and cued fear conditioning tasks. The learning deficits observed in these transgenic mice suggest that associative and spatial learning requires regulated Gsalpha protein signaling, much as does olfactory learning in Drosophila.     

The President’s New Freedom Commission: Capitalizing on Opportunities to Advance School-Based Mental Health Services

The report from President George W. Bush’s New Freedom Commission on Mental Health (NFC), Achieving the Promise: Transforming Mental Health Care in America(2003), proposes goals and recommendations for improving mental health services. This report has significant implications for the delivery of mental health services through the schools. A focused discussion of the potential opportunities and challenges of implementing NFC recommendations related to school-based mental health is presented. Strategies for addressing five key areas at the intersection of school mental health and the Commission’s recommendations include: stigma reduction, suicide prevention, expansion and improvement of school mental health, and screening and treatment of co-occurring mental health and substance abuse disorders.     

The regional genetic and newborn screening service collaboratives: the first two years

Newborn screening and genetic technologies are expanding and changing rapidly, increasing the demand for genetic specialty services. Because of the scarcity and geographic maldistribution of genetic specialty services, access to these services is a critical issue. This article discusses some of the efforts initiated by the Maternal and Child Health Bureau of the Health Resources and Services Administration, particularly the establishment of regional genetic and newborn screening collaboratives to improve access to these services and expertise.     

Resilient individuals use positive emotions to bounce back from negative emotional experiences

Theory indicates that resilient individuals "bounce back" from stressful experiences quickly and effectively. Few studies, however, have provided empirical evidence for this theory. The broaden-and-build theory of positive emotions (B. L. Fredrickson, 1998, 2001) is used as a framework for understanding psychological resilience. The authors used a multimethod approach in 3 studies to predict that resilient people use positive emotions to rebound from, and find positive meaning in, stressful encounters. Mediational analyses revealed that the experience of positive emotions contributed, in part, to participants' abilities to achieve efficient emotion regulation, demonstrated by accelerated cardiovascular recovery from negative emotional arousal (Studies 1 and 2) and by finding positive meaning in negative circumstances (Study 3). Implications for research on resilience and positive emotions are discussed.