Self-Acceptance Group Therapy: A Transdiagnostic,Cognitive-Behavioral Treatment for Shame

Shame has broad importance to psychological problems. However, few interventions specifically address shame, and most of these have been designed to target shame in the context of particular disorders. Self-Acceptance Group Therapy (SAGT) was developed as a transdiagnostic shame-focused treatment, based on a cognitive-behavioral framework. SAGT is an 8-week treatment that involves psychoeducation and training in the use of cognitive and behavioral shame regulation and support-building skills in order to promote self-acceptance. After describing SAGT, the study presented used an open trial design to examine the utility of SAGT for addressing shame, self-acceptance, quality of life, and relevant psychological problems (e.g., depression, social anxiety). Twenty-four outpatients with elevated shame were assessed at pretreatment, posttreatment, and 1-month follow-up. By post-treatment, results revealed significant improvements in self-acceptance, shame, and borderline personality disorder (BPD) symptoms among treatment completers (n = 18), with all of these improvements maintained at follow-up. Additionally, significant improvements in quality of life, emotion dysregulation, depression, loneliness, and stress were observed at follow-up. Results provide preliminary support for SAGT’s utility in the treatment of shame and related pathology among diverse outpatients.     

When expressing forgiveness backfires in the workplace: victim power moderates the effect of expressing forgiveness on transgressor compliance

Expressing (vs. withholding) forgiveness is often promoted as a beneficial response for victims. In the present research, we argue that withholding (vs. expressing) forgiveness can also be beneficial to victims by stimulating subsequent transgressor compliance – a response that is valuable in restoring the victim’s needs for control. Based on deterrence theory, we argue that a victim’s withheld (vs. expressed) forgiveness promotes transgressor compliance when the victim has low power, relative to the transgressor. This is because withheld (vs. expressed) forgiveness from a low-power victim elicits transgressor fear. On the other hand, because people are fearful of high-power actors, high-power victims can expect high levels of compliance from a transgressor, regardless of whether they express forgiveness or not. A critical incidents survey (Study 1) and an autobiographic recall study (Study 2) among employees, as well as a laboratory experiment among business students (Study 3), support these predictions. These studies are among the first to reveal that withholding forgiveness can be beneficial for low-power victims in a hierarchical context – ironically, a context in which offering forgiveness is often expected.     

The influence of making judgments of learning on memory performance: Positive,negative, or both?

Psychonomic Bulletin & Review - A common measure of memory monitoring——judgments of learning (JOLs)——has recently been shown to have reactive effects on learning. When...     

Violence,research, and non-identity in the psychiatric clinic

Violence in psychiatric clinics has been a consistent problem since the birth of modern psychiatry. In this paper, I examine current efforts to understand and reduce both violence and coercive responses to violence in psychiatry, arguing that these efforts are destined to fall short. By and large, scholarship on psychiatric violence reduction has focused on identifying discrete factors that are statistically associated with violence, such as patient demographics and clinical qualities, in an effort to quantify risk and predict violent acts before they happen. Using the work of Horkheimer and Adorno, I characterize the theoretical orientation of such efforts as identity thinking. I then argue that these approaches lead to epistemic imperceptiveness and a subtle form of conceptual restraint on patients. I suggest a reorientation in psychiatric research, away from identity thinking and toward a more productive and just approach to the problem of violence in psychiatric clinics.     

Investigating How Test-Takers Change Their Strategies to Handle Difficulty in Taking a Reading Comprehension Test: Implications for Score Validation

This article investigates how test-takers change their strategies to handle increased test difficulty. An adult sample reported their test-taking strategies immediately after completing the tasks in a reading test. Data were analyzed using structural equation modeling specifying a measurement-invariant, ability-moderated, latent transition analysis in Mplus (Muthén & Asparouhov, 2011). It was found that almost half of the test-takers (47%) changed their strategies when encountering increased task-difficulty. The changes were characterized by augmenting comprehending-meaning strategies with score-maximizing and test-wiseness strategies. Moreover, test-takers' ability was the driving influence that facilitated and/or buffered the changes. The test outcomes, when reviewed in light of adjusted test-taking strategies, demonstrated a form of process-based validity evidence.     

Getting stuck: temporal desituatedness in depression

The DSM characterizes major depressive disorder partly in temporal terms: the depressive mood must last for at least two weeks, and also must impact the subject "most of the day, nearly every day." However, from the standpoint of phenomenological psychopathology, the long-lasting quality of the condition hardly captures the distinctiveness of depression. While the DSM refers to objective time as measured by clocks and calendars, what is especially striking about depression is the distortions to lived time that it involves. But is there any relation between a) these disruptions to temporal experience and b) the tendency for depressive symptoms to persist and endure? To explore the connection between lived time and objective time, I investigate the embodied and enactive nature of intentionality among subjects suffering from depression. What I call 'affective framing' is a spontaneous, pre-reflective way of filtering information that involves bodily attunement and allows subjects to focus their attention on what they feel is important. I will argue that affective framing ordinarily has a forward-looking temporal structure and a "teleological direction" that is rooted in our embodiment. However, depression involves a distortion in future-directed intentionality, so that a subject becomes temporally desituated and cut off from the future. This contributes to many of the characteristic features of depression, including apparent lack of motivation, inability to imagine future possibilities, alterations in lived time, and a sense that one is "stuck." To gain a better understanding of this disruption to the futuredirected structure of affective framing in cases of depression, I look to concepts from complex dynamic systems theory and the notion of 'habit.' My proposed account aims to shed light on how a disruption to future-directedness impacts bodily attunement and reinforces depression as a long-term condition.     

Medical Students’ Efforts to Integrate and/or Reclaim Authentic Identity: Insights from a Mask-Making Exercise

Medical students’ mask-making can provide valuable insights into personal and professional identity formation and wellness. A subset of first- and second-year medical students attending a medical school wellness retreat participated in a mask-making workshop. Faculty-student teams examined student masks and explanatory narratives using visual and textual analysis techniques. A quantitative survey assessed student perceptions of the experience. We identified an overarching theme: “Reconciliation/reclamation of authentic identity.” The combination of nonverbal mask-making and narrative offers rich insights into medical students’ experience and thinking. This activity promoted reflection and self-care, while providing insight regarding personal and professional development.     

Validity of Adolescent and Parent Reports on the Six-Item ADHD Self-Report Scale (ASRS-6) in Clinical Assessments of Adolescent Social Anxiety

Adolescents experiencing social anxiety often experience co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms. Yet, assessing for social anxiety poses challenges given the already time-consuming task of distinguishing social anxiety from other commonly co-occurring internalizing conditions (e.g., generalized anxiety, major depression). Assessors need short screening devices to identify socially anxious adolescents in need of intensive ADHD assessments. A six-item version of the ADHD Self-Report Scale (ASRS-6) was originally developed to identify adults who likely meet diagnostic criteria for ADHD, but its psychometric properties have yet to be examined among adolescents. We tested the psychometric properties of the ASRS-6 when administered in clinical assessments for adolescent social anxiety. Eighty-nine 14–15 year old adolescents and their parents (67.4% female; 62.1% African American; 30 Clinic-Referred; 59 Community Control) completed the ASRS-6, measures of adolescent social anxiety and depressive symptoms, and parent-adolescent conflict. Adolescent self-reported and parent-reported ASRS-6 positively related with scores from established measures of social anxiety, depressive symptoms, and parent-adolescent conflict. Further, adolescent self-reported (but not parent-reported) ASRS-6 scores significantly discriminated adolescents on referral status. Adolescent self-reported (but not parent-reported) ASRS-6 scores incrementally predicted social anxiety over-and-above depressive symptoms, which commonly co-occur with social anxiety. Conversely, parent-reported (but not adolescent self-reported) ASRS-6 scores incrementally predicted parent-adolescent conflict over-and-above depressive symptoms, which commonly co-occur with conflict. When assessing adolescent ADHD symptoms, adolescents’ and parents’ reports meaningfully vary in their links to validity indicators. As such, among adolescents assessed for social anxiety, clinical assessments of adolescent ADHD symptoms should include both parent reports and adolescent self-reports.     

Maternal Depression in Families of Children with ADHD: A Meta-Analysis

Although research has demonstrated a relationship between maternal depression and child attention deficit/hyperactivity disorder (ADHD); the strength of the relationship is currently unclear. The results of some studies have found a strong association between maternal depression and child ADHD, while other studies have found little or no association. A meta-analysis was conducted to clarify the strength of the association between maternal depression and child ADHD. The current study included 51 published and unpublished studies that included a quantitative comparison between maternal depression and child ADHD. Mothers of children with ADHD had significantly higher levels of depressive symptoms than mothers of children without ADHD (d?=?0.58; 95% CI [0.43, 0.74]; p?<?.001; k?=?18). The relationship between maternal depressive symptoms and child ADHD symptoms was moderate (r?=?.22; 95% CI [.17, .28]; p?<?.001; k?=?21). 17.11% of mothers of children with ADHD currently met criteria for a depressive disorder (95% CI [11.95, 23.89], p?<?.001, k?=?19). The DSM version used to evaluate child ADHD status was the only moderator that was statistically significant (p?=?.021, k?=?15). Specifically, studies that used the DSM-III or DSM-III-R were associated with larger effect sizes than studies that used the DSM-IV or DSM-IV-TR. The results suggest that clinicians should screen for the possible co-occurrence of maternal depression when working with families of children with ADHD.     

Attachment styles and clinical correlates in people at ultra high risk for psychosis

Evidence suggests that attachment styles may influence subclinical psychosis phenotypes (schizotypy) and affective disorders and may play a part in the association between psychosis and childhood adversity. However, the role of attachment in the initial stages of psychosis remains poorly understood. Our main aim was to describe and compare attachment styles in 60 individuals at ultra high risk for psychosis (UHR) and a matched sample of 60 healthy volunteers (HV). The HV had lower anxious and avoidant attachment scores than the UHR individuals (p < .001). Sixty-nine percentage of the UHR group had more than one DSM-IV diagnosis, mainly affective and anxiety disorders. The UHR group experienced more trauma (p < .001) and more mood and anxiety symptoms (p < .001). Interestingly, in our UHR group, only schizotypy paranoia was correlated with insecure attachment. In the HV group, depression, anxiety, schizotypy paranoia, and social anxiety were correlated with insecure attachment. This difference and some discrepancies with previous studies involving UHR suggest that individuals at UHR may compose a heterogeneous group; some experience significant mood and/or anxiety symptoms that may not be explained by specific attachment styles. Nonetheless, measuring attachment in UHR individuals could help maximize therapeutic relationships to enhance recovery.