New Strategies for Combining Mindfulness with Integrative Cognitive Behavioral Therapy for the Treatment of Generalized Anxiety Disorder

Generalized anxiety disorder (GAD) severely impacts social functioning, distress levels, and utilization of medical care compared with that of other major psychiatric disorders. Neither pharmacological nor psychotherapy interventions have adequately controlled cardinal symptoms of GAD: pervasive excessive anxiety and uncontrollable worry. Research has established cognitive behavioral therapy (CBT) as the most effective psychotherapy for controlling GAD; however, outcomes remain at only 50% reduction, with high relapse rates. Mindfulness has been integrated with CBT to treat people suffering from numerous psychiatric disorders, with mindfulness based stress reduction (MBSR) being the most researched. Preliminary evidence supports MBSR’s potential for controlling GAD symptoms and key researchers suggest mindfulness practices possess key elements for treating GAD. Classical mindfulness (CM) differs significantly from MBSR and possesses unique potentials for directly targeting process and state GAD symptoms inadequately treated by CBT. This article introduces the theory and practice of CM, its differences from MBSR, and a critical review of MBSR and CBT treatments for GAD. CM strategies designed to complement CBT targeting cardinal GAD symptoms are outlined with a case study illustrating its use.     

Do intrusive memory characteristics predict depression at 6 months?

Two prospective studies have investigated whether the presence, intrusion, and avoidance of negative intrusive memories predict depression, and have reported conflicting findings. We aimed to replicate and extend these investigations by exploring the role of intrusion and avoidance of intrusive memories, as well as memory characteristics, in the prediction of depression prospectively. At Time 1 a mixed sample of community participants (N=85) were interviewed and completed self-report measures of depression, anxiety, and intrusive memory features. At Time 2 (6 months later, N=64) depression and anxiety symptoms were reassessed. Results were partly consistent with hypotheses for the sub-sample of participants who did not receive treatment between the baseline and follow-up assessments. Baseline levels of intrusion and some memory features (uncontrollability, distress, interference, numbness, detachment) predicted follow-up depression, controlling for baseline depression symptoms. Unexpectedly, avoidance of intrusive memories and other features (e.g., here and now quality) did not predict depression. Levels of intrusion and avoidance did not predict anxiety at follow-up. These results provide further evidence that intrusive memories are not simply an epiphenomenon of depression, but predict depression prospectively. Our results suggest that novel, depression-specific theories that emphasise the role of memory disturbances in the maintenance of depression are needed.     

Age-related differences in guessing on free and forced recall tests

This study examined possible age-related differences in recall, guessing, and metacognition on free recall tests and forced recall tests. Participants studied categorised and unrelated word lists and were asked to recall the items under one of the following test conditions: standard free recall, free recall with a penalty for guessing, free recall with no penalty for guessing, or forced recall. The results demonstrated interesting age differences regarding the impact of liberal test instructions (i.e., forced recall and no penalty) relative to more conservative test instructions (i.e., standard free recall and penalty) on memory performance. Specifically, once guessing was controlled, younger adults' recall of categorised lists varied in accordance with test instructions while older adults' recall of categorised lists did not differ between conservative and liberal test instructions, presumably because older adults approach standard free recall tests of categorised lists with a greater propensity towards guessing than young adults.     

Practicing what we know: Multicultural counseling competence among clinical psychology trainees and experienced multicultural psychologists

Multicultural (MC) competence is considered a necessary skill for clinical and counseling psychologists; however, there is little to no research on the assessment of demonstrated multicultural counseling competence (DMCCC) of clinical psychology graduate students. In this study, we developed a MC assessment instrument to assess DMCCC of clinical psychology graduate students compared with MC-experienced psychologists. In addition, we assessed for differences between the endorsement of MC-appropriate strategies and actual use of these strategies in clinical practice, both by MC-experienced psychologists and clinical psychology students. Results revealed significant differences between the DMCCC of clinical psychology graduate students and MC-experienced psychologists. Significant differences also emerged between endorsement of strategies as multiculturally appropriate and likelihood of actual use of these strategies. Findings suggest that future training and competence models should incorporate participants' ability to not only identify multiculturally appropriate strategies but also use these strategies in therapy.     

Effects of manifest ethnic identification on employment discrimination

Evidence from recent laboratory experiments suggests that ethnic identification can lead to negative evaluations of ethnic minorities (Kaiser & Pratt-Hyatt, 2009). The current research considers the generalizability of these findings to face-to-face interactions in contexts wherein impression management concerns are salient: the workplace hiring process. In a field experiment, Black, Hispanic, and Irish individuals applied for retail jobs with or without visible display of their ethnic identification. Analysis of indicators of formal (e.g., application offering, interview scheduling) and interpersonal discrimination (e.g., interaction length, nonverbal negativity) suggest store personnel interacting with other-race applicants exhibited greater positivity and longer interactions when applicants displayed ethnic identification than when they did not. The findings suggest that psychologists need to understand not only attitudes or intentions expressed in the lab, but also the behavioral consequences of manifest group identity as they unfold in natural environments.     

Breaking apart the typical mortality salience manipulation: Two questions,two outcomes

The typical mortality salience manipulation asks participants to reflect on two questions, one about the emotions associated with the thought of death and the other about what happens after one dies. In five experiments, we separated these two questions and gave participants either one or a control question. In Experiment 1, participants' responses to the afterlife question were coded as being informed more by cultural knowledge and values compared with responses to the emotion question. Experiments 2 and 3 demonstrated that participants responding to the afterlife question showed greater stereotype usage compared with those responding to the emotion or a control question. In Experiment 4, results illustrate that the afterlife and emotion question differ on various coding dimensions related to self‐focus, emotion, and culturally related death words, but not death‐related words. In addition, participants who responded to the afterlife question demonstrated greater cultural worldview defense by setting a higher bail for an alleged prostitute compared with those who answered the emotion or a control question. In Experiment 5, participants responding to the emotion question demonstrated a greater preference for personally endorsed values compared with those who responded to the emotion or a control question. These results suggest that the two questions used in the common mortality salience manipulation produce different results when separated. Copyright © 2012 John Wiley & Sons, Ltd.     

The experiences of living with a sibling who stutters: a preliminary study

Stuttering impacts on the child in a variety of ways, notably in terms of communicative impairment and psychosocial impact. In addition, the stuttering disorder has a holistic impact, affecting those with whom the child who stutters lives. Within the family constellation, the closest person to the individual who stutters is often their sibling. This study investigated the experiences of fluent siblings of children who stutter to examine the impact that stuttering may have on their lives. A mixed methods research design incorporated qualitative semi-structured interviews and quantitative questionnaires. The results of the qualitative investigation revealed four aspects of children's lives that were affected by having a sibling who stuttered: the relationship between siblings, the impact on the fluent sibling, the impact on the parent relationship with both children, and the impact on the sibling's relationship with others. Findings revealed that siblings of children who stutter exhibited strongly negative emotions, and differing levels of responsibility associated with their involvement in the actual stuttering management programme. Furthermore, for the fluent sibling, secondary to having a brother or sister who stuttered, communication with and attention from their parents was variable. The results of the quantitative component of the study revealed children who stutter and their siblings demonstrated significantly greater closeness, and concurrently, increased conflict and status disparity than did the control fluent sibling dyads. The parents of the experimental sibling dyads also demonstrated significantly greater partiality towards a child, namely the child who stuttered, than did the parents of the control sibling dyads. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) identify the themes associated with having a sibling who stutters; (2) identify how the quality of the sibling relationship differs between sibling dyads that do and do not consist of a sibling who stutters; and (3) discuss the clinical implications of the results with regards to working with children who stutter and their families.     

Young and older adults' beliefs about effective ways to mitigate age-related memory decline

This study investigated whether young and older adults vary in their beliefs about the impact of various mitigating factors on age-related memory decline. Eighty young (ages 18-23) and 80 older (ages 60-82) participants reported their beliefs about their own memory abilities and the strategies that they use in their everyday lives to attempt to control their memory. Participants also reported their beliefs about memory change with age for hypothetical target individuals who were described as using (or not using) various means to mitigate memory decline. There were no age differences in personal beliefs about control over current or future memory ability. However, the two age groups differed in the types of strategies they used in their everyday life to control their memory. Young adults were more likely to use internal memory strategies, whereas older adults were more likely to focus on cognitive exercise and maintaining physical health as ways to optimize their memory ability. There were no age differences in rated memory change across the life span in hypothetical individuals. Both young and older adults perceived strategies related to improving physical and cognitive health as effective means of mitigating memory loss with age, whereas internal memory strategies were perceived as less effective means for controlling age-related memory decline.     

An Inkblot for the Implicit Assessment of Personality: The Semantic Misattribution Procedure

Misattributions people make about their own reaction to ambiguous stimuli can be used to measure personality self‐concepts implicitly. On the basis of a semantic misattribution priming paradigm [semantic misattribution procedure (SMP)], we assessed the implicit personality self‐concept related to three dimensions included in the Big‐Five model: conscientiousness, neuroticism, and extraversion. Across three studies (N1 = 98, N2 = 140, and N3 = 135), the SMP was robustly related, in the expected direction, to individual differences in self‐reported personality questionnaires and managed to predict both self‐reported and objectively measured behaviours. The main advantage of SMP over classical explicit measures of personality is its higher resistance to social desirability tendencies, although its psychometric properties are somewhat lower than those pertaining to explicit measures of personality. Finally, comparisons of our results with studies that used other implicit measures of personality self‐concept indicate that the SMP has higher criterion validity. Copyright © 2012 John Wiley & Sons, Ltd.