Acceptance and Commitment Therapy for adults who stutter: Psychosocial adjustment and speech fluency

The aim of the present study was to assess the effectiveness of an Acceptance and Commitment Therapy group intervention program for adults who stutter (N = 20). The program consisted of 2-h therapeutic sessions conducted weekly for eight consecutive weeks. It was an integrated program designed to improve: (a) psychosocial functioning, (b) readiness for therapy and change, (c) utilisation of mindfulness skills and psychological flexibility, and (d) frequency of stuttering. The findings provide innovative evidence for Acceptance and Commitment Therapy as an effective intervention with statistically significant improvements in psychosocial functioning, preparation for change and therapy, utilisation of mindfulness skills, and overall speech fluency. Follow-up data collected at three months post-treatment revealed that therapeutic gains were successfully maintained over time. These findings enhance the understanding of the impact of stuttering on psychological wellbeing and offer a new perspective on what might constitute successful stuttering treatment. Further, clinical research support is provided for Acceptance and Commitment Therapy delivered in a group format as a promising and novel intervention for adults who stutter.Educational objectives: The reader will be able to: (a) appreciate the potential for Acceptance and Commitment Therapy for adults who stutter; (b) identify the improvements participants experienced in psychosocial functioning and frequency of stuttered speech; (c) appreciate the six core processes of Acceptance and Commitment Therapy; and (d) appreciate the differences between an ACT model of intervention for adults who stutter compared to a CBT approach.     

The Regulatory Easy Street: Self-Regulation Below the Self-Control Threshold Does not Consume Regulatory Resources

We present and test a theory in which self-control is distinguished from broader acts of self-regulation when it is both effortful and conscious. In two studies, we examined whether acts of behavioral management that do not require effort are exempt from resource depletion. In Study 1, we found that a self-regulation task only reduced subsequent self-control for participants who had previously indicated that completing the task would require effort. In Study 2, we found that participants who completed a self-regulation task for two minutes did not evidence the subsequent impairment in self-control evident for participants who had completed the task for four or more minutes. Our results support the notion that self-regulation without effort falls below the self-control threshold and has different downstream consequences than self-control.     

Temperament and common disruptive behavior problems in preschool

The study evaluated trait associations with common Disruptive Behavior Disorders (DBD), Oppositional Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), during an understudied developmental period: preschool. Participants were 109 children ages 3–6 and their families. DBD symptoms were available via parent and teacher/caregiver report on the Disruptive Behavior Rating Scale. Traits were measured using observational coding paradigms, and parent and examiner report on the Child Behavior Questionnaire and the California Q-Sort. The DBD groups exhibited significantly higher negative affect, higher surgency, and lower effortful control. Negative affect was associated with most DBD symptom domains; surgency and reactive control were associated with hyperactivity-impulsivity; and effortful control was associated with ADHD and inattention. Interactive effects between effortful control and negative affect and curvilinear associations of reactive control with DBD symptoms were evident. Temperament trait associations with DBD during preschool are similar to those seen during middle childhood. Extreme levels of temperament traits are associated with DBD as early as preschool.     

Lessons Learned in Looking Back: Perspectives from Trailblazers

Although this is in many ways a good era for women, many things have yet to improve. Women continue to lag behind men with regard to salaries, are under-represented in position of leadership, and still take on greater responsibility for child rearing and family responsibilities. Careers dominated by women tend to be associated with lower salaries and lower prominence and by the same token, women tend to dominate leadership positions when the field becomes less prestigious. Although women now outnumber men in graduating classes, the feminization of clinical psychology brings new challenges. This special series comes out of the 2009 trailblazer panel held at the ABCT convention in New York City, which explored the experiences faced by pioneering women in behavior therapy and discussed ways to help women overcome the glass ceiling. This introductory paper summarizes the lessons learned by these trailblazers with a view toward helping women in academia today.     

Concreteness of positive, negative, and neutral repetitive thinking about the future

Consistent with assertions that the adaptiveness of repetitive thinking is influenced by both its valence and style, Stöber (e.g., Stöber &; Borkovec, 2002) has argued that worry is characterized by a reduced concreteness of thought content and that the resulting abstractness contributes to its inhibition of some aspects of anxious responding. However, extant research does not provide a direct test of Stöber's reduced concreteness theory of worry. We sought to test Stöber's theory and to examine the adaptiveness of repetitive worrisome thinking by randomly assigning 108 participants to engage in five consecutive periods of repetitive thinking about positively, negatively, or neutrally valenced potential future events. Results based on coding of thought data indicated that (a) repetitive thinking became increasingly less concrete as periods progressed; (b) contrary to Stöber's theory, both negative and positive repetitive future thinking were more concrete than neutral repetitive future thinking (and did not differ from each other); and (c) abstractness of thought during negative repetitive future thinking was associated with reduced reports of imagery-based activity. Results based on self-reported affect indicated that negatively valenced repetitive future thinking was uniquely associated with initial decreases in anxious affect, followed by increased anxious affect that coincided with increased imagery-based activity. This suggests that worry is associated with a sequential mitigation of anxious meaning followed by a strengthening of anxious meaning over time. Theoretical and clinical implications of these findings are discussed.     

Written exposure as an intervention for PTSD: A randomized clinical trial with motor vehicle accident survivors

The present study examined the efficacy of a brief, written exposure therapy (WET) for posttraumatic stress disorder (PTSD). Participants were 46 adults with a current primary diagnosis of motor vehicle accident-related PTSD. Participants were randomly assigned to either WET or a waitlist (WL) condition. Independent assessments took place at baseline and 6-, 18-, and 30-weeks post baseline (WL condition not assessed at 30 weeks). Participants assigned to WET showed significant reductions in PTSD symptom severity at 6- and 18-week post-baseline, relative to WL participants, with large between-group effect sizes. In addition, significantly fewer WET participants met diagnostic criteria for PTSD at both the 6- and 18-week post-baseline assessments, relative to WL participants. Treatment gains were maintained for the WET participants at the 30-week post baseline assessment. Notably, only 9% of participants dropped out of WET and the WET participants reported a high degree of satisfaction with the treatment. These findings suggest that a brief, written exposure treatment may efficaciously treat PTSD. Future research should examine whether WET is efficacious with other PTSD samples, as well as compare the efficacy of WET with that of evidence-based treatments for PTSD.     

Co-Constructions of Gender and Ethnicity in New Zealand Television Advertising

This paper reports key findings from a content analysis of gender and ethnic depictions in a sample of 2,120 New Zealand prime-time television advertisements screened in 2006. The study explored the following questions: With what product categories are male and female White, Māori/Pasifika and Asian characters most commonly associated? What are the most common occupational roles of male and female White, Māori/Pasifika and Asian characters? The results reveal highly stereotypical depictions of women and men within each ethnic category. White men dominated advertisements for foodstuffs, telecommunications and financial/corporate/legal services and were over-represented as professionals/white collar workers, while White women were over-represented in advertisements for household products, personal products, and medical products and featured predominantly as homemakers. Māori/Pasifika men were over-represented as athletes and service and sales workers. Non-White women featured prominently within multi-ethnic groups in advertisements for personal grooming products and most frequently featured as glamour models, while non-White men were over-represented as blue collar workers. Largely absent were Māori/Pasifika women and Asians of both genders, potentially exacerbating the multiple axes of subordination encountered by these groups in the New Zealand context.     

Analysis of the US-preexposure effect in flavor acceptance conditioning

In three experiments, rats received exposure to a sucrose solution followed by conditioning with a neutral flavor as the conditioned stimulus (CS) and sucrose as the unconditioned stimulus (US). In Experiments 1 and 2, some rats were given both the preexposure and the conditioning phases in a highly familiar context (the homecage), whereas other animals received both phases in a novel and distinctive context. In both cases the magnitude of the conditioning effect was reduced by preexposure to the US. Experiment 3 directly assessed the possible role of contextual cues by changing the context between the exposure phase and the conditioning phase but found no loss of the US-preexposure effect in these conditions. These results lend no support to the blocking-by-context account of the US-preexposure effect; alternative interpretations are considered.     

A crisis in the analyst's life: self-containment, symbolization, and the holding space

Most analysts will experience some degree of crisis in the course of their working life. This paper explores the complex interplay between the analyst's affect during a crisis in her lifeü and the affective dynamics of the patient. The central question is "who or what holds the analyst"--especially in times of crisis. Symbolization of affect, facilitated by the analyst's self-created holding environment, is seen as a vital process in order for containment to take place. In the clinical case presented, the analyst's dog was an integral part of the analyst's self-righting through this difficult period; the dog functioned as an "analytic object" within the analysis.     

Disconnections of African American Public Housing Residents: Connections to Physical Activity, Dietary Habits and Obesity

African American (AA) and low SES populations report poor health behaviors and outcomes. This study aimed to increase understanding of barriers to participating in healthful behaviors and programs in AA residents of public housing. Twenty two apparently healthy, AA residents (50% female, M = 43.9 years) completed in depth interviews, which were taped, transcribed and analyzed using a constant comparison approach. Residents demonstrated some awareness of health recommendations, but described limited adherence. Physical activity for recreation was reported as primarily for youth, with adults engaging in limited physical activity (primarily incidental to other activities). Barriers reported by residents were both personal and environmental. Few residents were aware of local neighborhood opportunities for physical activity or healthful eating. Future efforts should focus on increasing understanding of health promoting behaviors and awareness and efficacy of residents to connect with the resources of their surrounding communities.