Engagement and outcome in the treatment of bulimia nervosa: first phase of a sequential design comparing motivation enhancement therapy and cognitive behavioural therapy

Despite the major advances in the development of treatments for bulimia nervosa, drop-outs and a lack of engagement in treatment, continue to be problems. Recent studies suggest that the transtheoretical model of change may be applicable to bulimia nervosa. The aim of this study was to examine the roles of readiness to change and therapeutic alliance in determining engagement and outcome in the first phase of treatment. One hundred and twenty five consecutive female patients meeting DSM-IV criteria for bulimia nervosa took part in a randomised controlled treatment trial. The first phase of the sequential treatment compared four sessions of either cognitive behavioural therapy (CBT) or motivational enhancement therapy (MET) in engaging patients in treatment and reducing symptoms. Patients in the action stage showed greater improvement in symptoms of binge eating than did patients in the contemplation stage. Higher pretreatment scores on action were also related to the development of a better therapeutic alliance (as perceived by patients) after four weeks. However, pretreatment stage of change did not predict who dropped out of treatment. There were no differences between MET and CBT in terms of reducing bulimic symptoms or in terms of developing a therapeutic alliance or increasing readiness to change. The results suggest that the transtheoretical model of change may have some validity in the treatment of bulimia nervosa although current measures of readiness to change may require modification. Overall, readiness to change is more strongly related to improvement and the development of a therapeutic alliance than the specific type of treatment.     

Seeking a phenomenological metaphysics: Henry's reference to Meister Eckhart

Continental Philosophy Review -     

The myth of upright vision. A psychophysical and functional imaging study of adaptation to inverting spectacles

The adaptation to inverting prisms and mirror spectacles was studied in four subjects over periods of six to ten days. Subjects showed rapid adaptation of visuomotor functions, but did not report return of upright vision. The persistence of the transformed visual image was confirmed by the subjects' perception of shape from shading. No alteration of the retinotopy of early visual cortical areas was seen in the functional magnetic resonance images. These results are discussed in the context of previous claims of upright vision with inverting prisms and mirror spectacles.     

Minority representation,tokenism, and well-being in army units

Racial and ethnic diversity is increasing in the US Army and women are moving into more combat roles. This puts minority soldiers at risk for being underrepresented in their work units. Tokenism theory predicts that when a work group has less than 15% representation in a social group, the numerically underrepresented minority (i.e., token) members are subject to three disadvantages: higher visibility, informal isolation, and role encapsulation. In the Army, where many companies contain small numbers of women and racial minorities, some soldiers may face additional stressors and constraints. We explored psychosocial, organizational, and health outcomes of all identifiable token women (N = 4,425) and Black soldiers (N = 5,040). Tokens were remarkably similar to non-tokens and majority soldiers on outcomes such as coping skills, adaptability, organizational trust, sleep, substance use, and pain. The intersection of token status in terms of race and gender was not related to any appreciable differences. One potential explanation is the shared Army culture that emphasizes group unity and the importance of the mission above individual characteristics and goals. The Army depends on cohesion, organizational identification, and commitment to the group in order to reduce stress and anxiety, and to maximize combat performance. For soldiers who have internalized this culture, it could be easier to see past individual differences such as gender and race and identify others in the unit as fellow soldiers primarily.     

Examining the validity of the family investment and stress models and relationship to children's school readiness across five cultural groups

Using the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) dataset, this study examined whether the family investment and the family stress models generalized to non-European American (EA) families. Specifically, we examined whether parenting processes mediated the association between family demographics and children's school readiness, and whether the pathways vary across cultural groups. Both models were most salient for EAs followed by African Americans (AAs) and Spanish-speaking Hispanics, but less so for English-speaking Hispanics (EHs) and Asian Americans. Findings indicated that sensitive parenting was a salient mediator between family demographics and children's school readiness for all groups except EHs; negative parenting and parent-child activities were salient mediators for EAs only.     

Psychotherapie, Globalisierung, Hartz?IV

The mental effects of globalization, the economic crisis and unemployment must not be underestimated. In general they have to be looked upon as a complex system of structural traumatization which is causing severe psychological mental disorders, such as depression. Not only that, a psychotherapist has to pay particular attention to this. More than in physical illnesses the psychotherapist has to be solidly united with the patient, which might also result in political action.     

The Effect of Embodied Temperature on Perceptions of Global Warming

Recent research has established that individuals?? perception of global warming is malleable such that individuals report that it is a more serious problem when they experience higher outdoor or indoor temperatures (Li et al. Psychological Science, 22(4), 454?C459, 2011; Risen and Critcher Journal of Personality and Social Psychology, 100(5), 777?C793, 2011). We extend these findings on the experience of actual temperature by testing whether the embodied experience of temperature, manipulated by participants chewing cinnamon or mint gum, can activate the concept of temperature and influence perception of global warming. As predicted, compared to those who did not chew gum, those experiencing embodied temperature through chewing gum reported greater concern for global warming, but not other social problems, and were more likely to volunteer for a global warming group on campus. This suggests that the physical experience of tasting cinnamon or mint gum activated the larger conceptual system of temperature changes that subsequently influenced beliefs about global warming.     

DIFFERENTIAL RESPONDING ACROSS THERAPISTS IN A FUNCTIONAL ANALYSIS: A CASE STUDY

False negative functional analysis (FA) results may be less likely when caregivers serve as therapists, as problem behavior may be more likely to occur in the presence of a caregiver than with a novel therapist. This case study both replicated and extended prior research on this topic. It provides an example of FA results differing between a caregiver and novel therapist and also showed that FA results may differ across caregivers when they serve as therapists. Copyright © 2012 John Wiley & Sons, Ltd.     

The prevalence of symptoms of Post-Traumatic Stress Disorder among soldiers with amputation of a limb or spinal injury: a report from a rehabilitation centre in Sri Lanka

Post-Traumatic Stress Disorder has been identified as one of the most commonly occurring mental illnesses in combatants. This study was conducted to determine the prevalence of Post-Traumatic Stress Disorder among soldiers who had undergone amputation of a lower or an upper limb or sustained a spinal cord injury in the battlefield, and to compare the prevalence among these categories. The research presented seeks to increase the awareness of this condition among those treating war casualties so that appropriate treatment choices could be made to address them. The study was carried out in 2009 at a rehabilitation centre for combatants of war. Data were collected from 96 male army veterans between the ages of 18-49 years using a pre-tested self-administered questionnaire based on the Diagnostic and Statistical Manual of Mental Disorders, the Impact of Event Scale and the PTSD symptom scale. Soldiers with injuries sustained at least four weeks prior to the study were selected by a convenience sampling technique. Soldiers with multiple injuries, head injuries or those diagnosed with psychiatric disorders were excluded. The results revealed that 41.7% of the study population was compatible with the diagnosis of Post-Traumatic Stress Disorder. Within the three groups, 42.5% of the lower limb amputees, 33.3% of the upper limb amputees and 45.7% of the participants with spinal cord injury had symptoms compatible with Post-Traumatic Stress Disorder. There was no difference between the prevalence among the different injury categories considered. This study highlights the need to pay more attention in providing psychological care as a part of the overall health management of injured combatants. Early preparation of soldiers for stressors of war and screening for and proper management of Post-Traumatic Stress Disorder will improve the overall outcome of rehabilitation.     

Translating intentions into sunscreen use: an interaction of self-efficacy and appearance norms

The study examines whether self-efficacy mediates between intention and behavior, and whether appearance norms and self-efficacy are additive or synergistic predictors of sunscreen use. At two measurement points in time, 14 weeks apart, 154 individuals responded to an online questionnaire. Moderated mediation was tested by hierarchical regression analyses. Self-efficacy mediated the intention-behavior relationship, whereas appearance norms emerged as a moderator of the self-efficacy-sunscreen use relationship. The model accounted for 22% of the behavior variance at time 2. For individuals who believe that they would look more attractive with a tan, self-efficacy did not have a strong effect on behavior. Thus, for skin-protection motivation to become effective, self-efficacy is needed in conjunction with less positive appearance norms. Implications for public health promotion and mass media sunscreen use campaigns are discussed.