Conducting Outcomes Research in a Clinical Practice Setting: The Effectiveness and Acceptability of Acceptance and Commitment Therapy (ACT) in a Partial Hospital Program

Multiple challenges exist integrating research into clinical practice, particularly in acute care settings where randomized controlled trials may be impractical or unethical. Partial or day hospitals are one such setting. As compared to outpatients and inpatients, relatively little research is conducted or reported in partial hospital program (PHP) patients, leaving providers in this setting without a solid empirical basis from which to draw. We report treatment outcomes and patient satisfaction from the first 750 patients enrolled in a clinical research PHP utilizing the acceptance and commitment therapy (ACT) treatment model. ACT is a well-established, transdiagnostic behavior therapy. However, to date no study has examined the use of ACT in acute day hospitals. We hypothesized that applying ACT with this patient group would result in significantly improved depression, anxiety, functioning, and quality of life from intake to discharge. We additionally expected that patients would report high satisfaction with ACT treatment groups. Patients (n = 750 full sample, n = 518 completed treatment) completed daily measures of symptoms, functioning, and ACT processes at intake and discharge, and postgroup satisfaction surveys. Results showed significant improvements in symptoms and impairment. ACT process variables also increased over the course of treatment. Importantly, patient satisfaction was high for all groups. Thus, ACT provides an appropriate, flexible, effective, and satisfactory model for this patient group. A comparison of our findings using ACT to the limited research using other models in PHP settings is discussed, as well as challenges in the overall process of integrating research into routine clinical care.     

Are teachers’ personal values related to their attitudes toward inclusive education? A correlational study

Social Psychology of Education - Inclusive education is a major challenge for educational systems. In order to better understand the background to teachers’ attitudes toward inclusive...     

Given What I Know: Seeing the Past as a Portal to an Intentional Future

Dr. Terrence Roberts is our second guest for the Hearing Our Elders series. Dr. Roberts is one of the Little Rock Nine, the first group of African American students to attend Little Rock Central High School in 1957. Interview segments are woven into the article, providing a historical and political context from which to understand the current national climate with regard to social justice and multicultural responsiveness. Dr. Roberts's interview revealed 6 critical themes: resilience, understanding context in the face of the status quo, reimagining language, choice as key to good mental health, use of the self as an intervention tool, and the importance of being historical in one's thinking. Intentionality is identified as a metatheme that asks the question of where one falls on the status quo versus change agent continuum. Dr. Terrence Roberts es nuestro segundo invitado en la serie Escuchar a Nuestros Mayores. El Dr. Roberts es uno de los Little Rock Nine, el primer grupo de estudiantes afroamericanos que estudiaron en la escuela Little Rock Central High School en 1957. Se insertan fragmentos de la entrevista en el artículo, lo que proporciona un contexto histórico y político desde el que se puede comprender el clima nacional actual respecto a la justicia social y la sensibilidad multicultural. La entrevista con el Dr. Roberts reveló 6 temas críticos: la resiliencia, comprender el contexto frente al status quo, reimaginar el lenguaje, la capacidad de elección como clave para una buena salud mental, el uso del autoconcepto como herramienta de intervención y la importancia de ser histórico en el pensamiento personal. La intencionalidad se identifica como un metatema que formula la pregunta de dónde se sitúa uno mismo a lo largo del continuo entre status quo y agente de cambio.     

Can we link emotional eating with the emotion regulation skills of adolescents?

Objective: A recent cross-sectional study showed that maternal rejection is associated with emotional eating of obese youngsters seeking treatment, and that this relation is mediated by maladaptive emotion regulation (ER) of the youngsters. We wanted to build on this study and investigate the relation between parental rejection, maladaptive ER and emotional eating in a community sample using longitudinal data.

Design: Participants were 81 youngsters between the ages of 10 and 16 years. Participants completed questionnaires assessing maternal and paternal rejection, ER strategies and emotional eating, at two time moments (M = 71 days between time moments). Latent change models were used to estimate level and change of each variable.

Results: Results showed that the levels of maternal rejection, maladaptive ER and emotional eating were related. The indirect effect of the level of maternal rejection on the level of emotional eating through the level of maladaptive ER was marginally significant. On average, maternal rejection showed no change over time, whereas the other variables decreased. The changes in the variables were not related.

Conclusion: The findings highlight the importance of assessing the emotional bond between mother and youngster and the ER of youngsters with an emotional eating style.     

Time’s up! Involvement of metamemory knowledge,executive functions,and time monitoring in children’s prospective memory performance

This study examined time-based prospective memory (PM) in children and explored the possible involvement of metamemory knowledge and executive functions in the use of an appropriate time-monitoring strategy depending on the ongoing task’s difficulty. Specifically, a sample of 72 typically developing children aged 4, 6, and 9 years old were given an original PM paradigm composed of both an ongoing procedural activity and a PM task. Half of the participants (expert group) were trained in the ongoing activity before the prospective test. As expected, results show that time monitoring had a positive effect on children’s PM performance. Furthermore, mediation analyses reveal that strategic time monitoring was predicted by metamemory knowledge in the expert group but only by executive functions in the novice group. Overall, these findings provide interesting avenues to explain how metamemory knowledge, strategy use, and executive functions interact to improve PM performance during childhood.     

Building Buddhism in England: The Flourishing of a Minority Faith Heritage

From the earliest days of Buddhism in Britain, individuals and communities have sought out buildings to provide locations where they might practise and teach Buddhism. In this paper, we focus on this neglected area of the study of minority faith traditions in Britain. Our research, which was commissioned by Historic England, examines how Buddhist communities have used buildings and what this tells us about how a minority tradition is initially established and how it subsequently changes and develops. In this context, we suggest that buildings are more than bricks and mortar and provide a richly rewarding analytical lens to tell stories about migration, socio-economic status, religious diversity and integration and the complexity of processes around secularisation and religious change, as well shifting policy agendas in the UK that have begun to take faith seriously. This contributes to deepening the picture of the migration and adaptation of Buddhism and Buddhist practice across the globe.     

P300 amplitude variations,prior probabilities,and likelihoods: A Bayesian ERP study

The capability of the human brain for Bayesian inference was assessed by manipulating probabilistic contingencies in an urn-ball task. Event-related potentials (ERPs) were recorded in response to stimuli that differed in their relative frequency of occurrence (.18 to .82). A veraged ERPs with sufficient signal-to-noise ratio (relative frequency of occurrence > .5) were used for further analysis. Research hypotheses about relationships between probabilistic contingencies and ERP amplitude variations were formalized as (in-)equality constrained hypotheses. Conducting Bayesian model comparisons, we found that manipulations of prior probabilities and likelihoods were associated with separately modifiable and distinct ERP responses. P3a amplitudes were sensitive to the degree of prior certainty such that higher prior probabilities were related to larger frontally distributed P3a waves. P3b amplitudes were sensitive to the degree of likelihood certainty such that lower likelihoods were associated with larger parietally distributed P3b waves. These ERP data suggest that these antecedents of Bayesian inference (prior probabilities and likelihoods) are coded by the human brain.     

Effect of Parenting and Peer Stressors on Cognitive Vulnerability and Risk for Depression among Youth

Parenting behaviors influence clinical depression among youth, but little is known about the developmental processes that may account for this association. This study investigated whether parenting is associated with the onset of clinical depression and depressive symptoms through negative cognitive style, particularly under conditions of high exposure to stressors, in a community sample of children and adolescents (N = 275; 59% girls). Observational methods were used to assess positive and negative parenting during a laboratory social-evaluative stressor task. Depressive symptoms and clinical depressive episodes were repeatedly assessed over an 18-month prospective follow-up period. Results supported a conditional indirect effect in which low levels of observed positive parenting during a youth stressor task were indirectly associated with an increased likelihood of experiencing an episode of depression and worsening depressive symptoms over the course of the study through youth negative cognitive style, but only for youth who also experienced a high number of peer stressors. These findings elucidate mechanisms through which problematic parenting may contribute to risk for the development of clinical depression during the transition into and across adolescence. Implications for depression interventions are discussed.