Intensive Family-Based Cognitive-Behavioral Therapy for Pediatric Obsessive-Compulsive Disorder: Applications for Treatment of Medication Partial- or Nonresponders

Serotonin reuptake inhibitor medications and cognitive-behavioral therapy (CBT) are both effective treatments for pediatric obsessive-compulsive disorder (OCD). Despite recommendations that youth with OCD be treated with CBT alone or together with serotonin reuptake inhibitor medication, many youth are treated with medication alone or with non-CBT psychotherapy initially. Although effective, symptom remission with medication alone is rare (e.g., only 21.4% of youth achieved remission with sertraline in the Pediatric OCD Treatment Study, 2004) and residual symptoms often remain (e.g., 58% of subjects in the March et al. [1998] sertraline trial were not considered treatment responders). This paper reviews the literature on the efficacy of CBT for pediatric OCD, particularly as it relates to the treatment of youth with prior inadequate response to medication. It also describes an intensive, family-based CBT program for children and adolescents with OCD and support for its efficacy among those with prior partial- or nonresponse to medication. Finally, we present a case study of an adolescent girl with OCD who participated in the intensive treatment program after having limited benefit from medication and non-CBT psychotherapy and experienced a favorable response.     

Happiness is in our Nature: Exploring Nature Relatedness as a Contributor to Subjective Well-Being

Nature relatedness (NR) describes the affective, cognitive, and experiential aspects of human–nature relationships (Nisbet in Environ Behav 41: 715–740, 2009). Evidence from three studies suggests that individual differences in NR are associated with differences in well-being. In study 1 (N = 184), we explore associations between NR and a variety of well-being indicators, and use multiple regression analyses to demonstrate the unique relationship of NR with well-being, while controlling for other environmental measures. We replicate well-being correlates with a sample of business people (N = 145) in Study 2. In study 3 (N = 170), we explore the influence of environmental education on NR and well-being, and find that changes in NR mediate the relationship between environmental education and changes in vitality. We discuss the potential for interventions to improve psychological health and promote environmental behaviour.     

The role of comorbid disruptive behavior in the clinical expression of pediatric obsessive-compulsive disorder

This study explored the impact of disruptive behavior disorder (DBD) comorbidity on a number of theoretically relevant outcomes among 192 children and adolescents with obsessive-compulsive disorder (OCD). Youth were divided into three groups: OCD Only, OCD+DBD comorbidity and OCD+Other comorbidity. Relative to those without a comorbid condition and those with any non-DBD comorbidity, comorbid DBD was associated with greater family accommodation and less symptom resistance. Youth with comorbid DBD exhibited greater OCD symptom severity, OCD-related impairment, anxiety, and internalizing problems than those with no comorbidity. Those with comorbid DBD were over 3.6 times as likely to be taking an atypical antipsychotic medication relative to children without comorbidity. The present results suggest that comorbid DBD contributes to more severe illness presentation above and beyond an OCD diagnosis alone, and may be associated with differing pharmacotherapy prescribing practices.     

Direction of association between targets in a RSVP task influences priming at very short but not long SOAs

When two targets are presented using rapid serial visual presentation (RSVP) and the interval between the targets is 200–500 ms, detection or identification of the second target is impaired. This impairment in second target report is known as the attentional blink (AB). This study sought to examine the impact of the direction of target association on priming during an AB task using very short and long SOAs. Two experiments were conducted using dual-stream RSVP tasks and targets that either shared an associative relationship or were unrelated to one another. The direction of association between the targets was also varied so that associatively related targets were presented in the forward (strongest association from target 1 to target 2) or backward directions of association (strongest association from target 2 to target 1). In Experiment 1 very short SOAs between targets (27–213 ms) were used. Priming was evident at the same SOAs for both targets presented in the backward direction of association. However, for targets presented in the forward direction of association, priming occurred for target 1 and target 2 at different SOAs. Experiment 2 used longer SOAs between targets (107 to 535 ms) and it was determined that while direction of association between the targets did not affect priming, there was a larger priming effect for target 2 than for target 1. The results of the two experiments indicate that direction of association between targets influences priming in RSVP tasks that use very short but not long SOAs. The results are discussed in relation to the two-stage response competition model of Potter et al. (J Exp Psychol Hum Percept Perform 28:1149–1162, 2002).     

Holism and eclecticism in the theory of concepts

Abstract

Howard (1992) defines concepts as the information that a person has about a category, and argues for an eclectic theory of concepts on the basis of this definition. We argue that this definition is unacceptable and hence that eclecticism does not follow. First, the definition is circular as it stands. Secondly, when it is modified to avoid circularity, it implies conceptual holism, according to which concepts are not useful explanatory constructs in psychology. Thirdly, we argue that Howard's argument relies essentially on this unacceptable definition: alternative accounts of concepts, namely categorisational or representational views, do not support it. Having countered the argument for eclecticism, we then argue against it directly on methodological grounds.     

Environmental Influences on Ethical Decision Making: Climate and Environmental Predictors of Research Integrity

It is commonly held that early career experiences influence ethical behavior. One way early career experiences might operate is to influence the decisions people make when presented with problems that raise ethical concerns. To test this proposition, 102 first-year doctoral students were asked to complete a series of measures examining ethical decision making along with a series of measures examining environmental experiences and climate perceptions. Factoring of the environmental measure yielded five dimensions: professional leadership, poor coping, lack of rewards, limited competitive pressure, and poor career direction. Factoring of the climate inventory yielded four dimensions: equity, interpersonal conflict, occupational engagement, and work commitment. When these dimensions were used to predict performance on the ethical decision-making task, it was found that the environmental dimensions were better predictors than the climate dimensions. The implications of these findings for research on ethical conduct are discussed.     

A Sensemaking Approach to Ethics Training for Scientists: Preliminary Evidence of Training Effectiveness

In recent years, we have seen a new concern with ethics training for research and development professionals. Although ethics training has become more common, the effectiveness of the training being provided is open to question. In the present effort, a new ethics training course was developed that stresses the importance of the strategies people apply to make sense of ethical problems. The effectiveness of this training was assessed in a sample of 59 doctoral students working in the biological and social sciences using a pre–post design with follow-up and a series of ethical decision-making measures serving as the outcome variable. Results showed not only that this training led to sizable gains in ethical decision making but also that these gains were maintained over time. The implications of these findings for ethics training in the sciences are discussed.