Depression, Disability, And Rehabilitation Services For Women

The purpose of this paper is to review scientific evidence for the co-occurrence of major depressive illness and disability, and to examine this phenomenon specifically for women in the United States today. Following a discussion of different ways of operationalizing the concept of disability, the analysis addresses gender biases in disability measurement as well as in recent research on depression and functional impairment. Next, the results of research regarding co-occurrence of disability and depression are reviewed, highlighting those studies focused specifically on women. Turning to research on rehabilitation services for those with psychiatric disabilities, studies suggest that service delivery models fail to address needs specific to women with mental illness in general, as well as those women experiencing severe depression. Thus, the analysis concludes with a series of suggestions and future directions for investigators seeking to better understand the linkages between depression, disability, and rehabilitation services for women.     

Sex differences in object location memory and spatial navigation in Long-Evans rats

In both humans and rodents, males typically excel on a number of tasks requiring spatial ability. However, human females exhibit advantages in memory for the spatial location of objects. This study investigated whether rats would exhibit similar sex differences on a task of object location memory (OLM) and on the watermaze (WM). We predicted that females should outperform males on the OLM task and that males should outperform females on the WM. To control for possible effects of housing environment, rats were housed in either complex environments or in standard shoebox housing. Eighty Long-Evans rats (40 males and 40 females) were housed in either complex (Complex rats) or standard shoebox housing (Control rats). Results indicated that males had superior performance on the WM, whereas females outperformed males on the OLM task, regardless of housing environment. As these sex differences cannot be easily attributed to differences in cognitive style related to linguistic processing of environmental features or to selection pressures related to the hunting gathering evolutionary prehistory of humans, these data suggest that sex differences in spatial ability may be related to traits selected for by polygynous mating strategies.     

Timed excitatory conditioning under zero and negative contingencies

Rats (rattus norvegicus) anticipated the arrival of a food pellet unconditioned stimulus (US) even when the conditioned stimulus (CS) signaled no overall change or a substantial decrease in the overall rate of US occurrence. Pellet USs were scheduled probabilistically in the intertrial interval at either an equivalent rate (Experiment 1) or a four times higher rate (Experiments 2 and 3) than in the CS, which included one fixed-time target US. Conditioning has been said to involve learning "whether" (contingency) the CS signals a change in the US, and if so, "when" (contiguity) the US is scheduled to arrive. Our results suggest that "when" trumps "whether," challenging the received view that a positive CS-US contingency is necessary for successful conditioning.     

A randomized trial comparing the efficacy of cognitive-behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face

OBJECTIVE: A major problem in the delivery of mental health services is the lack of availability of empirically supported treatment, particularly in rural areas. To date no studies have evaluated the administration of an empirically supported manual-based psychotherapy for a psychiatric condition via telemedicine. The aim of this study was to compare the relative efficacy and acceptability of a manual-based cognitive-behavioral therapy (CBT) for bulimia nervosa (BN) delivered in person to a comparable therapy delivered via telemedicine. METHOD: One hundred twenty-eight adults meeting DSM-IV criteria for BN or eating disorder-not otherwise specified with binge eating or purging at least once per week were recruited through referrals from clinicians and media advertisements in the targeted geographical areas. Participants were randomly assigned to receive 20 sessions of manual-based, CBT for BN over 16 weeks delivered either face-to-face (FTF-CBT) or via telemedicine (TV-CBT) by trained therapists. The primary outcome measures were binge eating and purging frequency as assessed by interview at the end of treatment, and again at 3- and 12-month follow-ups. Secondary outcome measures included other bulimic symptoms and changes in mood. RESULTS: Retention in treatment was comparable for TV-CBT and FTF-CBT. Abstinence rates at end-of-treatment were generally slightly higher for FTF-CBT compared with TV-CBT, but differences were not statistically significant. FTF-CBT patients also experienced significantly greater reductions in eating disordered cognitions and interview-assessed depression. However, the differences overall were few in number and of marginal clinical significance. CONCLUSIONS: CBT for BN delivered via telemedicine was both acceptable to participants and roughly equivalent in outcome to therapy delivered in person.     

Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment

Mental health systems need scalable solutions that can reduce the efficacy–effectiveness gap and improve mental health outcomes in community mental health service settings. Two major challenges to delivery of high-quality care are providers’ fidelity to evidence-based treatment models and children’s and caregivers’ engagement in the treatment process. We developed a novel, tablet-based application designed to enhance via technology the quality of delivery of trauma-focused cognitive-behavioral therapy (TF-CBT). We piloted its use in four community mental health service organizations using a blocked randomized controlled trial to examine the feasibility of implementing tablet-facilitated TF-CBT versus standard TF-CBT with 13 providers and 27 families. Provider fidelity and child engagement in treatment were observationally measured via session audio recording. Parent and child perceptions of the tablet application were assessed using structured interviews and mixed-method analyses. Providers actively and appropriately used tablet TF-CBT to facilitate treatment activities. Providers and families expressed high satisfaction with its use, demonstrating acceptability of this approach. Youth and caregivers in both conditions reported high alliance with their providers. Overall, we found that tablet-facilitated treatment is accepted by providers and families and may be integrated into mental health treatment with minimal training. Further study is needed to examine the extent to which technology-based applications may enhance the reach, quality, and clinical outcomes of mental health treatment delivered to children and families.     

Bedroom design and decoration: gender differences in preference and activity

This investigation examined gender differences in niche-building preference and activity among 238 8th and 9th grade boys and girls. A questionnaire was developed to measure both the actual and preferred bedroom content, bedroom design activity, and the level of perceived influence by the immediate and extended family, friends, and social institutions. Gender differences were identified for preference, activity, and influence in bedroom design and decoration. Girls and boys differed in the type of items contained in their bedrooms. Girls' rooms contained stuffed animals and pictures of people, including themselves, more frequently than the boys' rooms. In contrast, boys' rooms contained sports-related items, and things for building or that they had built themselves. Although bedroom design activity for both boys and girls was influenced by older teens, friends, media, and popular culture, boys (but not girls) were also influenced by their mothers, fathers, girlfriends, and activities such as sports, Boy or Girl Scouts, and music lessons.     

Assessing obsessive compulsive symptoms and cognitions on the internet: evidence for the comparability of paper and Internet administration

Administration of psychological questionnaires via the Internet has gained popularity in recent years and touts many advantages. However, before questionnaires that were originally developed as paper-and-pencil measures can be confidently administered over the Internet, it is necessary to document the equivalence of the paper and computer-generated versions [American Psychological Association. (1986). Guidelines for computer-based tests and interpretations. Washington, DC: American Psychological Association; Cohen, R.J., Swerdlik, M.E., & Smith, D.K. (1992). Psychological testing and assessment (2nd ed.). Mountain View, CA: Mayfield Publishing; Cronbach, L.J. (1990). Essentials in psychological testing (5th ed.). New York: Harper Collins; Meier, S. (1994). The chronic crisis in psychological measurement and assessment: A historical survey. San Diego: Academic Press; Schulenberg, S.E., & Yutrzenka, B.A. (2001). Equivalence of computerized and conventional versions of the Beck Depression Inventory- II (BDI-II). Current Psychology: Developmental, Learning, Personality, Social, 20, 216-230]. The current study tested this equivalence for the Obsessive Compulsive Inventory [Foa, E.B., Kozak, M.J., Salkovskis, P.M, Coles, M.E., & Amir, N. (1998). The validation of a new obsessive compulsive disorder scale: The obsessive-compulsive inventory. Psychological Assessment, 10(3), 206-214] and the Obsessive Beliefs Questionnaire-44 [Obsessive Compulsive Cognitions Working Group. (2005). Psychometric validation of the obsessive belief questionnaire and interpretation of intrusions inventory-Part 2: Factor analyses and testing of a brief version. Behaviour Research and Therapy, 43, 1527-1543] in an unselected student sample. Study results support the equivalence of these measures of obsessive compulsive disorder (OCD) symptoms and beliefs independent of administration method (paper versus secure project website). These findings create new opportunities for conducting OCD-related research online.     

Learning is impaired by activated intentions

Two experiments examined the task interference that sometimes accrues from having an intention. In standard prospective memory tasks, latency is often slower to an ongoing task performed concurrently with having an intention than it is when no intention is given. If the locus of this slowing resulted from different attentional allocation policies in the two cases, we predicted that the process of learning a word list would be impaired if participants had an intention rather than if they did not. Four different event-based prospective memory tasks were used in Experiment 1 to demonstrate that worse free recall of a word list resulted when studied with a concurrent intention than with a control condition that had no intention. In that experiment, linking an intention to a distal context that was to occur after learning did not impair free recall. Two time-based tasks were used in Experiment 2 to demonstrate that possessing a time-based prospective memory also hinders learning, unless the intention is linked to a future context that is expected to occur after the study session. In the latter case, no impairment was obtained.     

Variability discrimination in humans and animals: implications for adaptive action

Both humans and animals live in a rich world of events. Some events repeat themselves, whereas others constantly change. The authors propose that discriminating this stability, sameness, and uniformity from change, differentness, and diversity is fundamental to adaptive action. Evidence from many areas of behavioral science indicates that the discrimination of and preference for stimulus variability affects both human and animal action. Recent comparative research with humans and animals illustrates a promising approach to the study of these issues. Discovering and understanding the behavioral and neural processes related to stimulus variability and its consequences for behavior offer distinctive challenges and important new opportunities for psychologists and neuroscientists.     

Single-item vs multiple-item measures of stage of change in compliance with prescribed medications

The Stage of Change construct from the Transtheoretical Model of behavioral change has been widely utilized in the assessment of various health behaviors. The majority of these tests measure the Stage of Change construct using the single-item. multiple-choice format. This study validated the use of a single-item measure in measuring readiness to comply with taking a prescribed medication. A sample of 161 subjects tested the multiple-item Stage of Change measure, then a refined multiple-item survey was tested with 59 subjects. With the latter survey, discriminating subjects at the differing stages of change dimensions was difficult. A correlation of .91 was found for stage classifications between ratings on the single-item and multiple-item scales. The use of the single-item measure seems reasonable when assessing stage of change in compliance with prescribed medication.