Addressing Challenges in Individual Psychotherapy with Delusional Patients: A Case Study

Although cognitive-behavioral treatments for schizophrenia and other psychotic disorders demonstrate strong results in clinical trials, not all patients respond to these treatments. Common challenges in psychotherapy with delusional patients include a mismatch between the therapist’s and the patient’s expectations about the purpose of therapy, the patient’s lack of motivation to reduce delusional beliefs in service of other goals, and the patient’s dependence on the delusions in order to preserve an intact sense of self. This case highlights the value of integrating a psychodynamic perspective with cognitive-behavioral interventions to address challenges in psychotherapy with chronically delusional patients.     

When what you have is who you are: self-uncertainty leads individualists to see themselves in their possessions

Four studies tested whether uncertainty about the self-concept can motivate people, particularly individualists who define themselves in terms of their personal traits and characteristics, to perceive their material possessions as extensions of themselves (i.e., as self-expressive). In Study 1, European American participants rated their favorite pair of blue jeans as more self-expressive after being induced to feel self-uncertain, whereas Asian American participants did not. In Study 2, participants who scored high on a measure of individualism rated their cars as more self-expressive following a self-uncertainty manipulation. In Study 3, individualists (but not collectivists) rated their favorite possessions as more self-expressive after being subject to self-uncertainty; a manipulation of self-irrelevant uncertainty did not produce these results. In Study 4, thinking about a self-expressive (relative to utilitarian) possession bolstered self-certainty among individualists, but not collectivists. Implications for research on culture, the self-concept, and possessions are discussed.     

Individual Differences in Individualism and Collectivism Predict Ratings of Virtual Cities’ Liveability and Environmental Quality

The present research investigated individual differences in individualism and collectivism as predictors of people's reactions to cities. Psychology undergraduate students (N = 148) took virtual guided tours around historical cities. They then evaluated the cities’ liveability and environmental quality and completed measures of individualism and collectivism. Mediation analyses showed that people who scored high in self-responsibility (individualism) rated the cities as more liveable because they perceived them to be richer and better resourced. In contrast, people who scored high in collectivism rated the cities as having a better environmental quality because they perceived them to (1) provide a greater potential for community and social life and (2) allow people to express themselves. These results indicate that people's evaluations of virtual cities are based on the degree to which certain aspects of the cities are perceived to be consistent with individualist and collectivist values.     

Gender, social competence, and symptomatology in schizophrenia: a longitudinal analysis

The relationship between gender and social skill measured by performance on a role play test was examined in a sample of 57 schizophrenics, 33 affective disorder patients, and 20 nonpatient controls. Female schizophrenics were more skilled than male schizophrenics, but no gender differences were present in the affective patients or the controls. Longitudinal analyses conducted on the schizophrenic group indicated that the superior social skill of women was stable over the year following a symptom exacerbation. Symptoms and social adjustment improved for both men and women over the year, but did not differ according to gender. The implications of the results for gender differences in the long-term outcome of schizophrenia are discussed.     

Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

An Approach‐Inhibition Model of Employee Silence: The Joint Effects of Personal Sense of Power and Target Openness

When employees consciously withhold potentially important suggestions or concerns from those who may be able to act on that information, it can have serious implications for organizational performance. Yet there is research suggesting that, when faced with the choice of whether or not to raise an issue, employees often choose to remain silent. Our objective in this paper is to expand current theoretical understanding of why employees often remain silent and of situational factors that can lessen this tendency. Drawing on the approach‐inhibition theory of power, we argue that an employee's personal sense that he or she is lacking in power in relation to others at work is a key factor contributing to the decision to remain silent but that this effect is moderated by perceived target openness. We took a multimethod approach, testing these relationships across 3 studies: a laboratory experiment, a survey study of healthcare workers, and a survey study of employees working across a wide range of industries. Our findings suggest that, although silence is indeed rooted in the psychological experience of powerlessness, perceived target openness mitigates this relationship, encouraging employee to speak up when they would not otherwise do so.     

The experiences of short-term humanitarian aid workers in Haiti

A small group of humanitarian aid workers travelled to Port-au-Prince, Haiti six months after the 2010 earthquake to assist in recovery efforts at an orphanage. This study explores the experiences of these workers and how they coped with the challenges in Port-au-Prince. Participants kept a journal to record their daily experiences. A phenomenological methodology was used to analyse the data in this study. Themes included relationships and connections, faith/perspective, care of self and others, purpose, and perspective. Researchers concluded relief workers need more preparation and support during and after humanitarian trips as experiences significantly impact workers perspective of themselves and others.     

First graders' literacy and self-regulation gains: The effect of individualizing student instruction

We examined the effect of individualizing student instruction (ISI; N = 445 students, 46 classrooms) on first graders' self-regulation gains compared to a business-as-usual control group. Self-regulation, conceptualized as a constellation of executive skills, was positively associated with academic development. We hypothesized that the ISI intervention's emphasis on teacher planning and organization, classroom management, and the opportunity for students to work independently and in small groups would promote students' self-regulation. We found no main effect of ISI on self-regulation gains. However, for students with weaker initial self-regulation, ISI was associated with greater self-regulation gains compared to peers in control classrooms. The ISI effect on self-regulation was greater when the intervention was more fully implemented.     

Differences in Rapid Initiation and Termination of Voluntary Postural Sway Associated with Ageing and Falls-Risk

The authors examined differences between young adults (n = 25) and healthy older adults (n = 48) in reaction time and the relations between center of pressure (COP) and center of mass (COM) motions during rapid initiation and termination of voluntary postural sway. Older adults were divided into low and high falls-risk groups based on Physiological Profile Assessment scores of sensorimotor function. Low falls-risk older adults had slower reaction times during anteroposterior sway initiation and decreased COP–COM separation during anteroposterior and medialateral sway initiation and anteroposterior continuous voluntary sway compared with young adults. High falls-risk older adults had slower initiation and termination reaction times in all response directions and decreased COP–COM separation during sway initiation and continuous voluntary sway in the anteroposterior and medialateral directions compared with young adults. Compared with low falls-risk older adults, high falls-risk older adults had slower initiation and termination reaction times in all response directions and decreased COP–COM separation during medialateral continuous voluntary sway. Reaction time and COP–COM measures significantly predicted group status in discriminant models with sensitivities and specificities of 72–100%. Overall, these findings highlight important associations of age-related declines in sensorimotor function related to an increased risk of falling with slower postural reaction time and reduced postural stability.